Most Relevant Information
Provider Data
| NPI Number: | 1003643826 |
| Provider Name: | MARY CORLETO |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/16/2024 |
| Last Updated: | 09/16/2024 |
Provider Practice Location
12607 OSBORNE ST
PACOIMA
CA
913312129
Practice Location Phone/Fax
| Phone: | 8186680154 |
| Fax: |
Provider Mailing Location
12607 OSBORNE ST
PACOIMA
CA
913312129
Provider Mailing Phone/Fax
| Phone: | 8186680154 |
| Fax: |