Individual
MS. MARY HELEN ACEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335-4219
(951) 643-2340
Mailing address
14677 MERRILL AVE, FONTANA, CA 92335-4219
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42672
CA
Other
Enumeration date
10/04/2024
Last updated
11/15/2024
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