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Individual

AMY MARIKO ANDERSSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
245 N MURRAY ST, BANNING, CA 92220-5528
(951) 849-8812
(951) 755-8915
Mailing address
245 N MURRAY ST, BANNING, CA 92220-5528
(951) 849-8812
(951) 755-8915

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
08/12/2011
Last updated
08/12/2011
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