Individual
KELLY NICOLE GENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2850 ARTESIA BLVD, REDONDO BEACH, CA 90278-3419
(424) 275-9968
Mailing address
3510 N EL DORADO DR, LONG BEACH, CA 90808-3207
(562) 833-7125
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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