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Individual

MISS AMY ELIZABETH DIFFLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7000B S CENTER DR, CLEARLAKE, CA 95422-8131
(707) 533-3550
(707) 994-7092
Mailing address
PO BOX 1024, LUCERNE, CA 95458-1024
(707) 533-3550
(707) 994-7092

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
11/21/2012
Last updated
11/21/2012
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