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Organization
EVERGREEN EDUCATIONAL THERAPY LLC
Active
Organization
EVERGREEN EDUCATIONAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA LEPORE ET/P (EXECUTIVE DIRECTOR)
(626) 977-4211
Entity
Organization
Contact information
Practice address
709 E COLORADO BLVD STE 250, PASADENA, CA 91101-2159
(626) 214-8972
(626) 517-5083
Mailing address
709 E COLORADO BLVD STE 250, PASADENA, CA 91101-2159
(626) 214-8972
(626) 517-5083
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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