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Marissa Edmonds

Behavior Technician in Santa Fe, NM. Individual provider (NPI-1).

NPI number1770085367
StatusActive
Last updated in NPPESFeb 28, 2018

Details

NPI
1770085367
Entity type
Individual (NPI-1)
Name
Marissa Edmonds
Sex
Female
Sole proprietor
No
Enumeration date
Feb 28, 2018
Last updated
Feb 28, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician–NMYes

Practice location

4001 Office Court Dr Ste 706
Santa Fe, NM 87507-4958

Phone 505-395-9611

Mailing address

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807

Phone 818-345-2345

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