Individual
CORA NED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
3900 BIRCH ST STE 103, NEWPORT BEACH, CA 92660-2226
(949) 955-0010
Mailing address
1821 WESTFIELD WAY, LA HABRA, CA 90631-3375
(562) 756-7530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9266
CA
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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