Individual
AJA CHANTELLE KIRKLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3978 SORRENTO VALLEY BLVD STE 100, SAN DIEGO, CA 92121-1436
(858) 428-0222
Mailing address
5392 MOUNT ALIFAN DR, SAN DIEGO, CA 92111-2623
(818) 256-0998
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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