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1174542666
SUSAN LYNNE BLAINE
DAVIS, CA
NPI
1174542666
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFC33852)
Enumeration Date
2006-07-18
Last Update Date
2007-07-08
Business Address
Ms. SUSAN LYNNE BLAINE MFT
1260 LAKE BLVD SUITE 243
DAVIS, CA 95616-2614
Phone number: 530-297-1601
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Mailing Address
Ms. SUSAN LYNNE BLAINE MFT
1260 LAKE BLVD SUITE 243
DAVIS, CA 95616-2614
Phone number: 530-297-1601
Copy
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