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Individual

VIRIDIANA VILLICANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
688 COSTA AZUL ST, IMPERIAL, CA 92251-8004
(760) 879-7915
Mailing address
688 COSTA AZUL ST, IMPERIAL, CA 92251-8004
(760) 879-7915

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary

Other

Enumeration date
08/02/2023
Last updated
08/02/2023
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