Individual
CHOTINAN GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
115 FESLER ST, SANTA MARIA, CA 93454-5818
(805) 922-6597
Mailing address
115 FESLER ST, SANTA MARIA, CA 93454-5818
(805) 922-6597
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT33661
CA
Other
Enumeration date
02/12/2014
Last updated
06/26/2023
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