Individual
ADISA PTAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2829 W BURBANK BLVD STE 200, BURBANK, CA 91505-2300
(818) 639-3568
Mailing address
2829 W BURBANK BLVD STE 200, BURBANK, CA 91505-2300
(818) 639-3568
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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