Individual
IVY K LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9353 VALLEY BLVD STE C, ROSEMEAD, CA 91770-1923
(626) 842-7578
Mailing address
9353 VALLEY BLVD STE C, ROSEMEAD, CA 91770-1923
(626) 842-7578
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36551
CA
Other
Enumeration date
06/22/2012
Last updated
01/24/2023
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