Individual
BRANDON GARIVALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
15416 PETUNIA ST, FONTANA, CA 92336-0224
(909) 471-0946
Mailing address
15416 PETUNIA ST, FONTANA, CA 92336-0224
(909) 471-0946
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
36734
CA
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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