| Fragile X Life, Aba Group | |
|
26907 Saint Andrews Ln Valley Center CA 92082-6662 | |
| (760) 801-2015 | |
| Not Available |
| Full Name | Fragile X Life, Aba Group |
|---|---|
| Speciality | Behavior Analyst |
| Location | 26907 Saint Andrews Ln, Valley Center, California |
| Authorized Official Name and Position | Timica Rossetta Radden (BCBA) |
| Authorized Official Contact | 7608012015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fragile X Life, Aba Group Po Box 2137 Valley Center CA 92082-2137 Ph: (760) 801-2015 | Fragile X Life, Aba Group 26907 Saint Andrews Ln Valley Center CA 92082-6662 Ph: (760) 801-2015 |
| NPI Number | 1780249664 |
|---|---|
| Provider Enumeration Date | 05/06/2019 |
| Last Update Date | 05/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780249664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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