Individual
DR. GARY LEE BUSHWEILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
550 MAIN ST STE F2A, PLACERVILLE, CA 95667-5634
(530) 919-9579
Mailing address
550 MAIN ST STE F2A, PLACERVILLE, CA 95667-5634
(530) 919-9579
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY5340
CA
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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