Individual
MISS AMANDA MARIE CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
237 RACE ST, SAN JOSE, CA 95126-4823
(408) 971-9822
Mailing address
3523 AMBER DR, SAN JOSE, CA 95117-2905
(408) 515-6383
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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