Individual
MRS. MARY LETA ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4465 MAPLE ST, SAN DIEGO, CA 92105-4762
(619) 957-1717
Mailing address
4465 MAPLE ST, SAN DIEGO, CA 92105-4762
(619) 957-1717
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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