Individual
MISS ANYA KATZINA MANCILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1809 NATIONAL AVE, SAN DIEGO, CA 92113-2113
(619) 515-2515
Mailing address
594 IVY CT, CHULA VISTA, CA 91911-2503
(619) 410-5628
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14305
CA
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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