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General NPI Number Information
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NPI Number | 1518031426
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Entity Type | Individual
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Provider Name | GLENNIS CAROLYN ANDREWS
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1720 E 120TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90059-3052
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Country | US
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Telephone | 310-668-4356
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Fax |
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Provider Business Mailing Address
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Address Line | 711 S FIR AVE APT. 8
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City | INGLEWOOD
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State | CA
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Zip | 90301-3377
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Country | US
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Telephone | 310-671-0749
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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