Individual
GREG WOMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 N SCHOOL ST STE 308, LODI, CA 95240-2161
(209) 370-5901
Mailing address
104 N SCHOOL ST STE 308, LODI, CA 95240-2161
(209) 370-5901
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
07/23/2017
Last updated
07/21/2022
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