Provider Demographics
NPI:1063859494
Name:DRILL, CELIA M (BA, MFA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:CELIA
Middle Name:M
Last Name:DRILL
Suffix:
Gender:F
Credentials:BA, MFA, BCBA
Other - Prefix:
Other - First Name:POSITIVE
Other - Middle Name:CHANGE
Other - Last Name:BEHAVIORAL INC.
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA, MFA, BCBA
Mailing Address - Street 1:5501 DUNSMUIR AVE
Mailing Address - Street 2:
Mailing Address - City:DUNSMUIR
Mailing Address - State:CA
Mailing Address - Zip Code:96025-2013
Mailing Address - Country:US
Mailing Address - Phone:707-499-0736
Mailing Address - Fax:707-630-3780
Practice Address - Street 1:12594 ACORN ST.
Practice Address - Street 2:
Practice Address - City:CLEARLAKE OAKS
Practice Address - State:CA
Practice Address - Zip Code:95423
Practice Address - Country:US
Practice Address - Phone:074-990-7367
Practice Address - Fax:707-630-3780
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-12891103K00000X
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst