Individual
LUIS MADRIGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1305 E VINE ST, LODI, CA 95240-3179
(209) 331-7085
Mailing address
1305 E VINE ST, LODI, CA 95240-3179
(209) 331-7085
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
210013031
CA
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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