Individual
DORIE-MAE NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11441 SAN JUAN ST, LOMA LINDA, CA 92354-3315
(917) 562-1885
Mailing address
11441 SAN JUAN ST, LOMA LINDA, CA 92354-3315
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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