Elijah Mack
NPI #1194214213 in Grover Beach, California
Provider Information
- NPI Number
- 1194214213
- Entity Type
- Individual
- Name
- Elijah Mack
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Analyst
- Enumeration Date
- May 3, 2018
- Last Updated
- May 3, 2018
Practice Location
- Address
- 1986 BRIGHTON AVE
- City
- Grover Beach
- State
- California
- ZIP Code
- 93433-1816
- Phone
- (269) 352-3660
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Analyst |
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