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Individual
DR. MARY SPEASE
Active
Individual
DR. MARY SPEASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY24780
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY24780
CA
103TC0700X
Clinical Psychologist
Primary
PSY24780
CA
103TC1900X
Counseling Psychologist
PSY24780
CA
Other
Enumeration date
09/11/2007
Last updated
02/16/2016
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