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Individual

DR. SAM H. BOUMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., L.E.P.

Contact information

Practice address
1069 W 22ND ST, UPLAND, CA 91784-1283
(909) 896-8133
Mailing address
1069 W 22ND ST, UPLAND, CA 91784-1283
(909) 896-8133

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2654
CA

Other

Enumeration date
06/28/2012
Last updated
06/28/2012
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