Individual
ASHLEY MARIE MAVON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150-6305
(530) 573-7927
Mailing address
1900 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150-6305
(530) 573-7927
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
06/27/2024
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