Individual
EVITA ANNE WOOLSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 S EL CAMINO REAL, STE 218, SAN CLEMENTE, CA 92672
(949) 228-9674
Mailing address
800 S EL CAMINO REAL, SAN CLEMENTE, CA 92672-4274
(760) 525-6411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
19810
CA
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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