Individual
JESSICA AHDOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 W SUNSET BLVD, SUITE 510, LOS ANGELES, CA 90027-5861
(323) 644-9380
Mailing address
5000 W SUNSET BLVD, SUITE 510, LOS ANGELES, CA 90027-5861
(323) 644-9380
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
10341
CA
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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