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Individual

MRS. JENNIFER ANN DIAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
155 EL CAMINO REAL, TUSTIN, CA 92780-3601
(714) 501-8246
Mailing address
155 EL CAMINO REAL, TUSTIN, CA 92780-3601
(714) 501-8246

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist

Other

Enumeration date
04/09/2014
Last updated
04/09/2014
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