Individual
MAKISHA ALYCE LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2910 S ARCHIBALD AVE, SUITE A # 129, ONTARIO, CA 91761-7323
(818) 618-3182
Mailing address
2910 S ARCHIBALD AVE, SUITE A # 129, ONTARIO, CA 91761-7323
(818) 618-3182
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY24152
CA
Other
Enumeration date
06/01/2013
Last updated
07/25/2013
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