Individual
MRS. AMY CARYN BOLENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
1720 E 120TH STREET, LOS ANGELES, CA 90059
(424) 338-2430
Mailing address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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