Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | WA |
NPI | 1003374828 |
---|---|
Provider Name | Araceli Mercado |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Wenatchee, WA 98801-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2019 |
Last Update Date | 11/03/2019 |