Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003444688 |
---|---|
Provider Name | Cheyenne Melissa Mateus |
First Address | Yuba City, CA 95993-8979 |
Second Address | Marysville, CA 95901-3920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2020 |
Last Update Date | 30/03/2020 |