MARISSA DIANE BURGOYNE

ENCINO, CA
NPI1770926024
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: CA  PSY25601)
Enumeration Date2013-04-16
Last Update Date2013-04-16
Business Address
-- MARISSA DIANE BURGOYNE PsyD
17401 MARTHA ST
ENCINO, CA 91316-1324
Phone number: 310-487-5988
Mailing Address
-- MARISSA DIANE BURGOYNE PsyD
17401 MARTHA ST
ENCINO, CA 91316-1324
Phone number: 310-487-5988