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Individual

ALEXA POULTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12792 VALLEY VIEW ST, GARDEN GROVE, CA 92845-2526
(714) 337-6484
Mailing address
12792 VALLEY VIEW ST, GARDEN GROVE, CA 92845-2526

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CA

Other

Enumeration date
09/16/2022
Last updated
09/16/2022
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