Individual
GENA ANITA WANSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
(323) 948-0442
Mailing address
5715 S BROADWAY, LOS ANGELES, CA 90037-4131
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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