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Individual

RADIANCE BARBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
730 SUNRISE AVE STE 120, ROSEVILLE, CA 95661-4549
(916) 436-8687
Mailing address
1541 FALABELLA WAY, OLIVEHURST, CA 95961-4915

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
5576
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
E1192437
CA
Enumeration date
03/09/2018
Last updated
01/09/2024
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