Individual
MISS BREYAWNA LA'TECH AMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A., M.S.
Contact information
Practice address
2055 LINCOLN AVE, PASADENA, CA 91103-1324
(626) 798-6793
Mailing address
2055 LINCOLN AVE, PASADENA, CA 91103-1324
(951) 532-3276
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/03/2010
Last updated
04/27/2012
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