Individual
MICHELLE MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
14628 SYLVAN ST APT 202, VAN NUYS, CA 91411-1674
(818) 268-3091
Mailing address
14628 SYLVAN ST APT 202, VAN NUYS, CA 91411-1674
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9447
—
CA
01
—
NONE
NONE
—
Enumeration date
07/06/2020
Last updated
07/06/2020
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