Charlotte Marcoulis
Behavior Technician in Gardena, CA. Individual provider (NPI-1).
NPI number1417536350
StatusActive
Last updated in NPPESApr 7, 2021
Details
- NPI
- 1417536350
- Entity type
- Individual (NPI-1)
- Name
- Charlotte Marcoulis
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 7, 2021
- Certification date
- Apr 7, 2021
- Last updated
- Apr 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1149 W 190th St Ste 2200Gardena, CA 90248-4344
Phone 310-856-0800
Mailing address
18726 S Western Ave Ste 408Gardena, CA 90248-3858
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