Individual
JULIE THANTAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43909 30TH ST W, LANCASTER, CA 93536-5843
(661) 952-5000
Mailing address
43909 30TH ST W, LANCASTER, CA 93536-5843
(661) 952-5000
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A7251025
CALIFORNIA DRIVER'S LICENSE
CA
Enumeration date
04/09/2019
Last updated
04/09/2019
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