Individual
GRACIELLA G SQUARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1771 E FLAMINGO RD STE 220AV, LAS VEGAS, NV 89119-5155
(619) 410-3680
Mailing address
1250 SANTA CORA AVE APT 735, CHULA VISTA, CA 91913-1556
(619) 410-3680
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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