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Individual

ANTOINETTE MARIA SANGALANG BANTUG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7351 W CHARLESTON BLVD STE 120, LAS VEGAS, NV 89117-1572
(702) 470-0624
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807

Taxonomy

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

Other

Enumeration date
02/04/2020
Last updated
02/04/2020
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