Individual
AMBER NICOLLE COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2545 MIMOSA DR, SAN BERNARDINO, CA 92407-2239
(909) 991-6565
Mailing address
2545 MIMOSA DR, SAN BERNARDINO, CA 92407-2239
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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