Individual
ANTONIA MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6795 SKYVIEW PL NW, BREMERTON, WA 98311-8946
(877) 712-2735
Mailing address
7391 E MAPLE ST, PORT ORCHARD, WA 98366-8435
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
60802307
WA
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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