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1134243165
ELLERY BENTLEY
SAN DIEGO, CA
NPI
1134243165
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFT38523)
Enumeration Date
2007-03-16
Last Update Date
2011-03-08
Business Address
-- ELLERY BENTLEY
2535 KETTNER BLVD
SAN DIEGO, CA 92101-1250
Phone number: 619-615-0701
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Mailing Address
-- ELLERY BENTLEY
2535 KETTNER BLVD
SAN DIEGO, CA 92101-1250
Phone number: 619-615-0701
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