Basic Information
| Provider Information | |||||||||
| NPI: | 1669919239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUNN-ARVINGER | ||||||||
| FirstName: | LEE | ||||||||
| MiddleName: | |||||||||
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| Credential: | RBT, BCBA | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 800 FERRARI | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917645030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094842848 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 800 FERRARI | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917645030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094842848 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2017 | ||||||||
| LastUpdateDate: | 04/03/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-15-06021 | CA | N | 103K00000X | 1-17-25280 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.