Individual
AMERICA IBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2629 CLARENDON AVE, HUNTINGTON PARK, CA 90255-4119
(323) 584-3700
Mailing address
2756B WILLOW PL, SOUTH GATE, CA 90280-2817
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ASW119477
CA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/05/2023
Last updated
01/24/2024
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