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1588448773
LAVENDER MICALO
LOS ANGELES, CA
NPI
1588448773
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-08-21
Last Update Date
2023-08-21
Business Address
LAVENDER MICALO
885 TIVERTON DRIVE
LOS ANGELES, CA 90095-0001
Phone number: 310-825-6373
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Mailing Address
LAVENDER MICALO
885 TIVERTON DRIVE
LOS ANGELES, CA 90095-0001
Phone number: 310-825-6373
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