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Organization
SOURCE THERAPY LICENSED CLINICAL SOCIAL WORKER SERVICES APC
Active
Organization
SOURCE THERAPY LICENSED CLINICAL SOCIAL WORKER SERVICES APC
Active
Other names
Michelle M. Colarusso, LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN BOWE-MCLEOD (BILLING MANAGER)
(760) 433-7944
Entity
Organization
Contact information
Practice address
1582 W SAN MARCOS BLVD STE 105, SAN MARCOS, CA 92078-4081
(760) 522-7158
(760) 539-7357
Mailing address
1582 W SAN MARCOS BLVD STE 105, SAN MARCOS, CA 92078-4081
(760) 522-7158
(760) 539-7357
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
27130
CA
Other
Enumeration date
05/02/2018
Last updated
02/17/2023
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