Individual
SHELLA R THORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
47915 OASIS ST, INDIO, CA 92201-6950
(760) 863-8600
Mailing address
47915 OASIS ST, INDIO, CA 92201-6950
(760) 863-8600
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT27232
CA
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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