Individual
MARILYNN C KUBISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAS II
Contact information
Practice address
17727 E CYPRESS ST, COVINA, CA 91722-2634
(626) 967-2677
Mailing address
17727 E CYPRESS ST, COVINA, CA 91722-2634
(626) 967-2677
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
01-026961
CA
Other
Enumeration date
09/02/2014
Last updated
09/03/2014
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