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Individual

MARISSA ALLYSA PORTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
810 6TH ST, TAFT, CA 93268-2306
(661) 765-2127
Mailing address
1300 17TH ST FL CLF4, BAKERSFIELD, CA 93301-4504

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary

Other

Enumeration date
09/13/2024
Last updated
09/13/2024
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