Individual
DEBORAH FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23133 VENTURA BLVD STE 103, WOODLAND HILLS, CA 91364-1184
(818) 715-9517
Mailing address
23133 VENTURA BLVD STE 103, WOODLAND HILLS, CA 91364-1184
(818) 715-9517
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
639982
CA
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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