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1306529615
CARLY PORTILLO
COSTA MESA, CA
NPI
1306529615
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 127855)
Enumeration Date
2023-08-11
Last Update Date
2023-08-11
Business Address
CARLY PORTILLO
2651 IRVINE AVE STE 122
COSTA MESA, CA 92627-6645
Phone number: 714-507-6884
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Mailing Address
CARLY PORTILLO
2651 IRVINE AVE STE 122
COSTA MESA, CA 92627-6645
Phone number: 714-507-6884
Copy
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