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Individual

JAMIE BLANCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1940 BASELINE RD, LA VERNE, CA 91750-2148
(909) 392-1344
(909) 392-1344
Mailing address
1940 BASELINE RD, LA VERNE, CA 91750-2148

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3710
CA

Other

Enumeration date
10/22/2018
Last updated
12/08/2022
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