Individual
LOLA JONTIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RAD T
Contact information
Practice address
418 1/2 HELIOTROPE AVE, CORONA DEL MAR, CA 92625
(786) 683-6166
Mailing address
418 1/2 HELIOTROPE AVE, CORONA DEL MAR, CA 92625
(786) 683-6166
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
133N00000X
Nutritionist
—
—
246Y00000X
Health Information Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
FL
Enumeration date
10/18/2022
Last updated
10/18/2022
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