Individual
CRYSTAL ANN WEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1411 W 190TH ST STE 110, GARDENA, CA 90248-4370
(714) 909-4325
Mailing address
1411 W 190TH ST, GARDENA, CA 90248-4324
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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