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Individual

MS. DENISE LASSALLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MFT ATR

Contact information

Practice address
1927 FAIRGATE COURT, FOLSOM, CA 95630
(916) 983-7202
Mailing address
1927 FAIRGATE CT, FOLSOM, CA 95630-6167
(916) 983-7202

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
MB24136
CA

Other

Enumeration date
11/02/2006
Last updated
07/08/2007
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