Individual
DR. CAROL ANNE WAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
874 GRAVENSTEIN AVE, SUITE 7, SEBASTOPOL, CA 95472-4555
(707) 321-0803
Mailing address
874 GRAVENSTEIN AVE, SUITE 7, SEBASTOPOL, CA 95472-4555
(707) 321-0803
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
PSY 13828
CA
103TC0700X
Clinical Psychologist
Primary
PSY 13828
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY 13828
CA
103TP2701X
Group Psychotherapy Psychologist
PSY 13828
CA
Other
Enumeration date
11/01/2008
Last updated
11/01/2008
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