Individual
MIA ILEENE SIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 W TORRANCE BLVD STE 100, REDONDO BEACH, CA 90277-3600
(310) 374-3300
(310) 374-3307
Mailing address
119 W TORRANCE BLVD STE 100, REDONDO BEACH, CA 90277-3600
(310) 374-3300
(310) 374-3307
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-25-16334
CA
Other
Enumeration date
07/19/2023
Last updated
10/09/2025
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