Individual
ANNISA PALOMA EXLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1925 E DAKOTA AVE, FRESNO, CA 93726-4821
(559) 600-9180
Mailing address
1925 E DAKOTA AVE, FRESNO, CA 93726-4821
(559) 600-9180
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
129094
CA
Other
Enumeration date
11/09/2021
Last updated
05/06/2025
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