Individual
TERESE ANN MCGILLIVRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15643 SHERMAN WAY, VAN NUYS, CA 91406-4135
(818) 788-4121
Mailing address
4851 ATOLL AVE, SHERMAN OAKS, CA 91423-2107
(818) 235-2010
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
1773
CA
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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