Individual
MARIAH MICHELLE DAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1529 W SIDONIA ST, HANFORD, CA 93230
(559) 670-4748
Mailing address
4411 E KINGS CANYON RD # 319, FRESNO, CA 93702-3604
(559) 892-1128
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
38198
CA
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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