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Individual

DR. MARY J ROTHERAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
10920 WILSHIRE BLVD, SUITE 350, LOS ANGELES, CA 90024-6502
(310) 794-8278
(310) 794-8297
Mailing address
10920 WILSHIRE BLVD, SUITE 350, LOS ANGELES, CA 90024-6502
(310) 794-8278
(310) 794-8297

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY 6558
CA

Other

Enumeration date
10/26/2006
Last updated
07/08/2007
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