Individual
AMANDA BIANCA CORRAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 S GRAND AVE, GLENDORA, CA 91740-5000
(626) 335-5980
Mailing address
1160 S GRAND AVE, GLENDORA, CA 91740-5000
(626) 335-5980
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
103118
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/07/2020
Last updated
08/17/2021
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