Individual
CARLEE ANTILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3125 MYERS ST, RIVERSIDE, CA 92503-5527
(951) 358-4850
Mailing address
3125 MYERS ST, RIVERSIDE, CA 92503-5527
(951) 358-4850
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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