Individual
AGIEE SOPHIA VILLASENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9620 CHESAPEAKE DR, SAN DIEGO, CA 92123-1369
(657) 242-2079
Mailing address
4148 CAMINO LITA, SAN DIEGO, CA 92122-1822
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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