Individual
MISS SUMMER MARIAH CARRANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA CSD, CERT SLPA
Contact information
Practice address
18837 BROOKHURST ST STE 109, FOUNTAIN VALLEY, CA 92708-7301
(714) 861-9595
Mailing address
5415 E 29TH ST, LONG BEACH, CA 90815-1027
(562) 400-2015
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
8101
CA
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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