Individual
DIANNE GULLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 E MARKET ST, LONG BEACH, CA 90805-5910
(562) 428-4681
Mailing address
225 W 3RD ST APT 112, LONG BEACH, CA 90802-3006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16764
CA
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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