Elisha Gardner

NPI #1992268148 in Montclair, California

Provider Information

NPI Number: 1992268148
Entity Type: Individual
Name: Elisha Gardner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 12, 2019
Last Updated: Apr 12, 2019

Practice Location

Address: 4950 SAN BERNARDINO ST STE 101
City: Montclair
State: California
ZIP Code: 91763-2328
Phone: (800) 249-1266

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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