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1053742239
MARY VILLAVICENCIO
SAN BERNARDINO, CA
NPI
1053742239
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-12-12
Last Update Date
2014-01-27
Business Address
-- MARY VILLAVICENCIO
104 W 4TH ST
SAN BERNARDINO, CA 92415-0035
Phone number: 909-382-7880
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Mailing Address
-- MARY VILLAVICENCIO
104 W 4TH ST
SAN BERNARDINO, CA 92415-0035
Phone number: 909-382-7880
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