NPI | 1841655545 |
---|---|
Former Legal Business Name | WELLSPRING PSYCHOLOGY |
Entity Type | Organization |
Authorized Contact | RICHARD JOSHUA MADDOX President 408-357-4102 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25909) |
Enumeration Date | 2015-12-22 |
Last Update Date | 2021-10-08 |