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Organization
CONVERGENT BRAIN DIAGNOSTICS
Active
Organization
CONVERGENT BRAIN DIAGNOSTICS
Active
Other names
MotlMD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARYJO BROOKS-MOTL LMFT (VICE PRESIDENT/CLINICAL DIRECTOR)
(916) 836-0036
Entity
Organization
Contact information
Practice address
4359 TOWN CENTER BLVD STE 217, EL DORADO HILLS, CA 95762-7113
(916) 836-0036
(916) 345-7950
Mailing address
4359 TOWN CENTER BLVD STE 217, EL DORADO HILLS, CA 95762-7113
(916) 836-0036
(916) 345-7950
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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