Individual
GINA DEFOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4335 ATLANTIC AVE, LONG BEACH, CA 90807-2803
(562) 216-4900
(562) 484-3039
Mailing address
4335 ATLANTIC AVE, LONG BEACH, CA 90807-2803
(562) 216-4900
(562) 484-3039
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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