Individual
MARIAH KRI'SHANDA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 RAMONA EXPY STE 1, PERRIS, CA 92571-7014
(951) 349-4195
Mailing address
838 E MAIN ST, SAN JACINTO, CA 92583-4412
(951) 337-8575
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
11/22/2020
Last updated
11/22/2020
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