Healthcare Provider Details
I. General information
NPI: 1114133592
Provider Name (Legal Business Name): MELINDA APRIL GARBUTT L.V.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11902 ROSECRANS AVE
NORWALK CA
90650-4197
US
IV. Provider business mailing address
11902 E ROSECRANS BLVD
NORWALK CA
90650
US
V. Phone/Fax
- Phone: 562-929-7188
- Fax: 562-929-7575
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: