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1922211036
ILENE MALT
SAN RAFAEL, CA
NPI
1922211036
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS12371)
Enumeration Date
2007-05-07
Last Update Date
2007-07-08
Business Address
-- ILENE MALT
1330 LINCOLN AVE SUITE 307
SAN RAFAEL, CA 94901-2120
Phone number: 415-454-2734
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Mailing Address
-- ILENE MALT
1330 LINCOLN AVENUE SUITE 307
SAN RAFAEL, CA 94901
Phone number: 415-454-2734
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