Individual
MRS. JILLIAN LEIGH TAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ED.S
Contact information
Practice address
8882 BELLSHIRE DR, HUNTINGTON BEACH, CA 92646-4615
(714) 330-8277
Mailing address
8882 BELLSHIRE DR, HUNTINGTON BEACH, CA 92646-4615
(714) 330-8277
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4437
CA
103TS0200X
School Psychologist
4437
CA
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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