Individual
MARISA MENDIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
47915 OASIS ST, INDIO, CA 92201-6950
(760) 863-8600
Mailing address
81820 SHADOW PALM AVE APT 102, INDIO, CA 92201-4050
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/04/2023
Last updated
08/20/2025
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