Individual
KORY LEANN MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
508 S 2ND AVE, COVINA, CA 91723-3012
(626) 974-8122
(626) 974-8198
Mailing address
4834 ALTA DR, SAN BERNARDINO, CA 92407-2988
(909) 573-6887
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
31629
CA
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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