Individual
LAURA GRACE STULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3350 LA JOLLA VILLAGE DR, 116B, SAN DIEGO, CA 92161-0002
(858) 242-8066
Mailing address
3565 ALBATROSS ST, APT 4, SAN DIEGO, CA 92103-4837
(574) 361-2114
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/22/2012
Last updated
06/22/2012
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