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General NPI Number Information
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NPI Number | 1225868136
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Entity Type | Individual
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Provider Name | BLANCA EIMEE HERNANDEZ IBARRA
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Gender | Female
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Dates
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Enumeration Date | 08/05/2024
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 301 E FOOTHILL BLVD STE 100
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City | ARCADIA
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State | CA
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Zip | 91006-2551
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Country | US
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Telephone | 833-319-3969
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Fax |
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Provider Business Mailing Address
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Address Line | 515 TAMAR DR
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City | LA PUENTE
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State | CA
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Zip | 91746-2631
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Country | US
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Telephone | 626-733-3650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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