Diana S Poulson

NPI 1114241205 - Marriage & Family Therapist - 106H00000X

NPI Details
NPI 1114241205
Gender Female
Enumeration Date 03/18/2010
Last Updated 03/18/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
7765 HEALDSBURG AVE
SEBASTOPOL CA, 95472-3309, US
Phone (707) 824-4782
Fax
Business Location
708 GRAVENSTEIN HWY N
#339
SEBASTOPOL CA, 95472-2808, US
Phone (707) 824-4782
Fax
Toxanomy
Taxonomy Code 106H00000X
License State California
License Number MFC34244
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According to our database, Diana S Poulson NPI is 1114241205, taxonomy code is 106H00000X and license number is MFC34244, license state is located at California. Diana S Poulson physically located at 7765 Healdsburg Ave, Sebastopol CA, 95472-3309. NPI Number Diana S Poulson has the Individual type.

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1114241205 NPI number is provided on an as is basis without warranty of any kind. 1114241205 is maintained by the National Plan & Provider Enumeration System. The contents of Diana S Poulson are for informational purposes only.