Individual
CHANTELL LACY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
490 W 14TH ST, LONG BEACH, CA 90813-2943
(562) 591-8701
Mailing address
490 W 14TH ST, LONG BEACH, CA 90813-2943
(562) 591-8701
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/16/2010
Last updated
03/04/2011
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