Individual
RAYGENALD JACQUES PIERRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
11031 JERRY LN, GARDEN GROVE, CA 92840-3318
(619) 840-6043
Mailing address
11031 JERRY LN, GARDEN GROVE, CA 92840-3318
(619) 840-6043
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1438
CA
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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