Individual
ALTIVISE LASHUN HARPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDCC
Contact information
Practice address
21101 DALE EVANS PKWY, APPLE VALLEY, CA 92307-9356
(310) 626-2858
Mailing address
15581 KEOKUK WAY, VICTORVILLE, CA 92395-5503
(310) 626-2858
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9003
CA
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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