Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 980001093 | CA |
NPI | 1346481728 |
---|---|
Provider Name | Mrs. Priscilla Baguise Villabroza |
First Address | La Mirada, CA 90638-5919 |
Second Address | La Mirada, CA 90638-5919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2009 |
Last Update Date | 16/03/2009 |