Individual
KATIANA CHARMAYNE BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335
(951) 643-2340
Mailing address
1145 BLAZEWOOD ST, RIVERSIDE, CA 92507-5908
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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