Individual
DANIELLE BOLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 STATE ST, SALEM, OR 97301-5861
(971) 273-7502
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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