Organization
SOVEREIGNDARITY LABORATION GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATRICE MATTHEWS (OWNER)
(818) 903-4015
Entity
Organization
Contact information
Practice address
14521 BIRCHWOOD CT, SYLMAR, CA 91342-1469
(818) 903-4015
Mailing address
18017 CHATSWORTH ST # 255, GRANADA HILLS, CA 91344-5608
(818) 903-4015
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
06/03/2023
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