Mariah Polster-Enriquez
Behavior Technician in Apple Valley, CA. Individual provider (NPI-1).
NPI number1982309837
StatusActive
Last updated in NPPESMar 31, 2023
Details
- NPI
- 1982309837
- Entity type
- Individual (NPI-1)
- Name
- Mariah Polster-Enriquez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 31, 2023
- Certification date
- Mar 31, 2023
- Last updated
- Mar 31, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
19848 Haida RdApple Valley, CA 92307-5547
Phone 760-217-4989
Mailing address
19848 Haida RdApple Valley, CA 92307-5547
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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