| NPI | 1689019812 |
|---|---|
| Former Name | MARK JEFFREY DOMBECK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25695) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY25695) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY25695) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2017-11-19 |