Individual
DEBRA STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14540 HAMLIN ST STE B, VAN NUYS, CA 91411-4147
(818) 997-6876
Mailing address
14540 HAMLIN ST STE B, VAN NUYS, CA 91411-4147
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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