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1871840009
LIZA L BOLANOS
SAN DIEGO, CA
NPI
1871840009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA LMFT94583)
Enumeration Date
2012-08-07
Last Update Date
2019-01-29
Business Address
LIZA L BOLANOS
1051 PICADOR BLVD
SAN DIEGO, CA 92154-3548
Phone number: 619-628-3665
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Mailing Address
LIZA L BOLANOS
2351 CARDINAL LANE ANNEX B
SAN DIEGO, CA 92123
Phone number: 858-573-2227
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