Sally Diane ED.D

NPI 1114162047 - Marriage & Family Therapist - 106H00000X

NPI Details
NPI 1114162047
Gender Female
Enumeration Date 12/05/2008
Last Updated 06/16/2010
Entity Type Individual
Active Over 8 years ago
Practice Location
79100 KRISTEN CT
LA QUINTA CA, 92253-7205, US
Phone (760) 777-0167
Fax
Business Location
42525 RANCHO MIRAGE LN
RANCHO MIRAGE CA, 92270-4312, US
Phone (760) 777-0167
Fax
Toxanomy
Taxonomy Code 106H00000X
License State California
License Number MFC 44515
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According to our database, Dr. Sally Diane ED.D NPI is 1114162047, taxonomy code is 106H00000X and license number is MFC 44515, license state is located at California. Sally Diane ED.D physically located at 79100 Kristen Ct, La Quinta CA, 92253-7205. NPI Number Sally Diane ED.D has the Individual type.

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1114162047 NPI number is provided on an as is basis without warranty of any kind. 1114162047 is maintained by the National Plan & Provider Enumeration System. The contents of Sally Diane ED.D are for informational purposes only.