Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1013163443 |
---|---|
Provider Name | Cristina Noelle Mardirossian |
First Address | Glendale, CA 91208-1669 |
Second Address | Glendale, CA 91208-1669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 14/08/2010 |