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Individual

BALA SRIRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, MAT, MT, CCC-SLP

Contact information

Practice address
6400 LAUREL CANYON BLVD STE 400, N HOLLYWOOD, CA 91606-1564
(818) 763-0136
(818) 763-3838
Mailing address
2743 SANTA ROSA AVE, ALTADENA, CA 91001-1940
(626) 398-3472

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP12169
CA

Other

Enumeration date
12/14/2009
Last updated
12/14/2009
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