Individual
LAURA VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1874 WEST AVE, SANTA ROSA, CA 95407-6306
(707) 975-1869
Mailing address
1874 WEST AVE, SANTA ROSA, CA 95407-6306
(707) 975-1869
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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