Individual
AMANDA MARIONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1370 S STATE ST STE A, SAN JACINTO, CA 92583-4922
(951) 791-3350
Mailing address
PO BOX 1697, PERRIS, CA 92572-1697
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
113510
CA
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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