Individual
EUGENIA MARIA DIAZ MOGOLLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3498 GREEN VALLEY RD, RESCUE, CA 95672-9625
(530) 391-8670
Mailing address
3498 GREEN VALLEY RD, RESCUE, CA 95672-9625
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
5585
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5585
SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY AND HEARING AID DISPENSERS BOARD
CA
Enumeration date
09/19/2018
Last updated
04/17/2020
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