Individual
BLANCA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 GOODRICH BLVD, COMMERCE, CA 90022-5102
(323) 888-9191
Mailing address
1011 GOODRICH BLVD, COMMERCE, CA 90022-5102
(323) 888-9191
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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