Individual
MRS. CAITLIN MICHELLE PETRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S HAVEN AVE STE 190, ONTARIO, CA 91761-2971
(909) 390-1313
Mailing address
5925 SYCAMORE CANYON BLVD APT 13, RIVERSIDE, CA 92507-8464
(951) 398-8468
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
25935
CA
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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