Individual
CHLOE BETH FORMICHELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 MEADOW LARK DR, SAN DIEGO, CA 92123-2709
(951) 674-9243
Mailing address
2801 MEADOW LARK DR, SAN DIEGO, CA 92123-2709
(858) 298-6231
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/10/2008
Last updated
09/22/2022
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