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1003209685
SUSIE JULIANA BAUTISTA
SAN LUIS OBISPO, CA
NPI
1003209685
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
Enumeration Date
2015-03-06
Last Update Date
2015-03-06
Business Address
-- SUSIE JULIANA BAUTISTA
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401-4535
Phone number: 805-781-4960
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Mailing Address
-- SUSIE JULIANA BAUTISTA
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401-4535
Phone number:
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