Individual
KELLY RAE STAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13066 VAN NUYS BLVD, PACOIMA, CA 91331-2576
(818) 206-3353
Mailing address
17216 SATICOY ST, VAN NUYS, CA 91406-2103
(916) 761-5113
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
CA
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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