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1013040245
MARIA REGINA LARDIZABAL MICO
MODESTO, CA
NPI
1013040245
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-03-14
Last Update Date
2007-07-08
Business Address
Mrs. MARIA REGINA LARDIZABAL MICO
707 14TH ST
MODESTO, CA 95354-2506
Phone number: 209-525-6041
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Mailing Address
Mrs. MARIA REGINA LARDIZABAL MICO
3824 LOUISBURG AVE
MODESTO, CA 95357-1324
Phone number: 209-525-7432
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