Individual
MARY B SHARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23701 E EAST FORK RD, AZUSA, CA 91702-1477
(626) 910-1202
(626) 910-1380
Mailing address
1406 GRIFFITH AVE, LA PUENTE, CA 91744-1235
(626) 918-0679
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT32873
CA
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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