Facts
- Status
- A
- Credential
- SLP
- Type
- Individual
- Enumeration date
- 2017-12-15
- Last updated
- 2017-12-15
Specialties
Licenses
- License CA
- SP6051
Location
- Practice location
- 1490 N CLAREMONT BLVD
- City
- CLAREMONT CA
- Postal code
- 917113519
- Phone
- 626-355-1729
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.