Individual
MS. CALLIE WILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1149 W 190TH ST STE 2300, GARDENA, CA 90248-4350
(310) 892-5812
Mailing address
236 MANHATTAN AVE APT 2, HERMOSA BEACH, CA 90254-5133
(901) 413-1307
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18989
CA
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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