Individual
BLESSY CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH-LANGUAGE PATH
Contact information
Practice address
706 N DIAMOND BAR BLVD STE B2, DIAMOND BAR, CA 91765-1059
(909) 396-8900
(909) 396-9900
Mailing address
706 N DIAMOND BAR BLVD STE B2, DIAMOND BAR, CA 91765-1059
(909) 396-8900
(909) 396-9900
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP23793
CA
Other
Enumeration date
07/08/2017
Last updated
07/08/2017
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