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Individual
MARIAN R. C. EDELBROCK
Active
Individual
MARIAN R. C. EDELBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY15260
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY152600
—
CA
Enumeration date
09/07/2006
Last updated
10/07/2008
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