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LIDA SUAN ABRAHAM SPEECH PATHOLOGIST

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1104104538

Individual Registrant:
 LIDA SUAN ABRAHAM SPEECH PATHOLOGIST
Gender: F
Sole Proprietor

Location and contact information for practice:
706 N DIAMOND BAR BLVD STE B  DIAMOND BAR, CA 91765-1059 US
Tel: 909-396-8900  Fax: 909-396-9900

Contact information for business:
706 N DIAMOND BAR BLVD STE B  DIAMOND BAR, CA 91765-1059 US
Tel: 909-396-8900  Fax: 909-396-9900

Registration Information:
NPI: 1104104538
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
CA17413

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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