Individual
ALICE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 E COMMONWEALTH AVE STE 208, FULLERTON, CA 92832-1905
(562) 217-2124
Mailing address
140 E COMMONWEALTH AVE STE 208, FULLERTON, CA 92832-1905
(562) 217-2124
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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