Organization
YOUTHFUL CREATIONS AND INTERVENTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY D ROSEBOROUGH (OWNER)
(909) 543-9974
Entity
Organization
Contact information
Practice address
3667 N PLUM TREE AVE, RIALTO, CA 92377-2701
(909) 543-9974
Mailing address
3667 N PLUM TREE AVE, RIALTO, CA 92377-2701
(909) 543-9974
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
02/01/2023
Last updated
07/10/2023
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