Mitra Wesley
Behavior Technician in San Jose, CA. Individual provider (NPI-1).
NPI number1003454232
StatusActive
Last updated in NPPESDec 18, 2019
Details
- NPI
- 1003454232
- Entity type
- Individual (NPI-1)
- Name
- Mitra Wesley
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 18, 2019
- Certification date
- Dec 18, 2019
- Last updated
- Dec 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
871 Coleman Ave # 209San Jose, CA 95110-1831
Phone 877-264-6747
Mailing address
1663 Mission St Ste 400San Francisco, CA 94103-2485
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