Individual
CALVENA MONIQUE BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1350 3RD ST, LA VERNE, CA 91750-5201
(909) 596-5921
Mailing address
978 SPRINGFIELD ST APT C, UPLAND, CA 91786-3038
(909) 452-4139
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
35082
CA
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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