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Individual

BONNIE ROE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPT

Contact information

Practice address
6500 MORRO RD STE D, ATASCADERO, CA 93422-4142
(805) 459-2826
Mailing address
7620 CASTANO AVE, ATASCADERO, CA 93422-5233
(805) 459-2826

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41652
CA

Other

Enumeration date
10/07/2024
Last updated
10/07/2024
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