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1962576223
ELLEN MARIE THEOBALD
RIVERSIDE, CA
NPI
1962576223
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY9953)
Enumeration Date
2006-11-20
Last Update Date
2007-07-08
Business Address
Mrs. ELLEN MARIE THEOBALD PhD
5015 CANYON CREST DR SUITE 203
RIVERSIDE, CA 92507
Phone number: 951-369-7416
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Mailing Address
Mrs. ELLEN MARIE THEOBALD PhD
5307 STONEWOOD DR
RIVERSIDE, CA 92506
Phone number: 951-683-2684
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