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Individual

MS. HEIDI D KNIPE LAIRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1325 AUTO PLAZA DR, SUITE 110, SAN BERNARDINO, CA 92408
(909) 885-0411
(951) 784-1841
Mailing address
PO BOX 5922, 1325 AUTO PLAZE DR SUITE 110, SAN BERNARDINO, CA 92408
(909) 885-0411
(951) 784-1841

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
CA PSY 10935
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33BE10
RIVERSIDE COUNTY DCS
CA
05
9455029
CA
Enumeration date
12/06/2006
Last updated
07/08/2007
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