ELLEN SUSAN LODGE

ATASCADERO, CA
NPI1710040993
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  19187)
Enumeration Date2006-12-18
Last Update Date2007-07-08
Business Address
Ms. ELLEN SUSAN LODGE LCSW
6470 LEWIS AVE
ATASCADERO, CA 93422-4229
Phone number: 805-264-4050
Mailing Address
Ms. ELLEN SUSAN LODGE LCSW
PO BOX 6395
LOS OSOS, CA 93412-6395
Phone number: 805-264-4050
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