NPI | 1740556489 |
---|---|
Entity Type | Organization |
Authorized Contact | PAMELA MEGHAN TIEDEMANN-FULLER Licensed Clinical Psychologist 707-556-2356 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY23513) |
Enumeration Date | 2012-03-27 |
Last Update Date | 2012-03-27 |