Individual
MISS GENESIS BASCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
810 BRIAR PRIVADO, ONTARIO, CA 91762-6820
(951) 660-8351
Mailing address
810 BRIAR PRIVADO, ONTARIO, CA 91762-6820
(951) 660-8351
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP33408
CA
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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