Kelsee Deroos
Behavior Technician in Rancho Cucamonga, CA. Individual provider (NPI-1).
NPI number1366073280
StatusActive
Last updated in NPPESJan 29, 2020
Details
- NPI
- 1366073280
- Entity type
- Individual (NPI-1)
- Name
- Kelsee Deroos
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 29, 2020
- Certification date
- Jan 29, 2020
- Last updated
- Jan 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
8350 Archibald Ave Ste 110Rancho Cucamonga, CA 91730-3670
Phone 800-434-8923
Mailing address
25864 Lawton AveLoma Linda, CA 92354-3801
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