Individual
MS. AUDRA DENISE CARLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6501 VAN NUYS BLVD STE 103, VAN NUYS, CA 91401-1425
(818) 902-5315
Mailing address
6717 FULTON AVE APT 4, VALLEY GLEN, CA 91401-1226
(818) 263-3724
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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