Individual
KRISTIN ETHEREDGE MICHAELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
78290 VIA PAVION, LA QUINTA, CA 92253-4855
(808) 214-2100
Mailing address
78290 VIA PAVION, LA QUINTA, CA 92253-4855
(808) 214-2100
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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