Individual
CORALIE WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LEP 2804
Contact information
Practice address
6960 DESTINY DR STE 112, ROCKLIN, CA 95677-2995
(916) 296-0564
Mailing address
6960 DESTINY DR STE 112, ROCKLIN, CA 95677-2995
(916) 296-0564
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2804
CA
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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