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Individual

MILA ROSE DOMINGO REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2515 E JEFFERSON ST, CARSON, CA 90810-1519
(310) 830-7803
Mailing address
23421 MAIN ST, CARSON, CA 90745-5231
(310) 999-5247

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
704541
CA

Other

Enumeration date
07/19/2021
Last updated
07/19/2021
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