Individual
MRS. RICHELLE JEANNINE DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLT, MT
Contact information
Practice address
15117 HAYNES ST., VAN NUYS, CA 91411-1418
(818) 901-6555
(818) 901-6555
Mailing address
15117 HAYNES ST., VAN NUYS, CA 91411-1418
(818) 901-6555
(818) 901-6555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
225000000X
Orthotic Fitter
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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