STEPHANIE MARIE DEATHERAGE

COSTA MESA, CA
NPI1669090346
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  ASW103089)
Enumeration Date2020-07-09
Last Update Date2024-09-29
Business Address
Mrs. STEPHANIE MARIE DEATHERAGE
3505 CADILLAC AVENUE BUILDING O, SUITE 110
COSTA MESA, CA 92626-1429
Phone number: 949-290-0114
Mailing Address
Mrs. STEPHANIE MARIE DEATHERAGE
21881 UTE WAY
LAKE FOREST, CA 92630-3548
Phone number: 949-290-0114
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