Individual
LUZ MACIAS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14445 OLIVE VIEW DR, SYLMAR, CA 91342-1438
(747) 210-8448
Mailing address
11623 MITLA AVE, DOWNEY, CA 90241-4335
(310) 531-4068
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
5229-T
CA
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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