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1902326507
MELISSA LEE VAN WAGENEN
REDWOOD CITY, CA
NPI
1902326507
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA IMF96544)
Enumeration Date
2017-06-23
Last Update Date
2017-06-23
Business Address
MELISSA LEE VAN WAGENEN LMFTI
643 BAIR ISLAND RD # 301
REDWOOD CITY, CA 94063-2754
Phone number: 650-424-0852
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Mailing Address
MELISSA LEE VAN WAGENEN LMFTI
PO BOX 92152
PASADENA, CA 91109-2152
Phone number: 818-720-9152
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