Individual
MISS CHUNTRELL EVETTE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 N LA BREA AVE, SUITE 500, INGLEWOOD, CA 90301-1752
(310) 677-7808
Mailing address
257 S GRAPE AVE, COMPTON, CA 90220-6703
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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