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1487283685
MIRIAM FAGAN
SAN RAFAEL, CA
NPI
1487283685
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA 31718)
Enumeration Date
2020-04-08
Last Update Date
2024-04-02
Business Address
Dr. MIRIAM FAGAN PSYD
111 SMITH RANCH RD
SAN RAFAEL, CA 94903-1939
Phone number: 415-491-3003
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Mailing Address
Dr. MIRIAM FAGAN PSYD
775 E BLITHEDALE AVE # 141
MILL VALLEY, CA 94941-1554
Phone number: 415-569-5113
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