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1760981732
GRACE WAKIM
PETALUMA, CA
NPI
1760981732
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103T00000X Psychologist
(Licence: CA 29666)
Enumeration Date
2018-02-06
Last Update Date
2019-04-22
Business Address
GRACE WAKIM PSYD
3900 LAKEVILLE HWY MOB 2
PETALUMA, CA 94954-5968
Phone number: 707-765-3565
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Mailing Address
GRACE WAKIM PSYD
1160 N DUTTON AVE STE 230
SANTA ROSA, CA 95401-4658
Phone number: 707-303-3243
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