Individual
MS. COURTNEY IDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9701 DINO DR STE 170, ELK GROVE, CA 95624-4042
(916) 892-0013
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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