Individual
MISS MARY CHAMBERLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
10065 OLD GROVE RD, SAN DIEGO, CA 92131-1664
(858) 444-8823
(858) 444-8827
Mailing address
140 MURRAY ST, CHULA VISTA, CA 91910-5907
(619) 213-3212
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-09-3749
CA
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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