Ivy Glaze Vidad
Ivy Glaze Vidad is a Behavior Technician in Stockton, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2018
Practice location Address checks out
2453 Grand Canal Blvd Ste AStockton, CA 95207-8259
Phone: (855) 223-7123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X · Licence 1212345 (CA) |
|---|
Record details
| NPI number | 1700393428 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | January 3, 2018 |
| Last updated in NPPES | August 19, 2021 |
| Certification date | August 19, 2021 |
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