Individual
MRS. DIANE MARIE BOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
710 RIMPAU AVE SUITE 104, CORONA, CA 92879
(951) 377-2138
Mailing address
710 RIMPAU AVE SUITE 104, CORONA, CA 92879
(951) 377-2138
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY17101
CA
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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