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Individual

STEPHANIE T. IMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2107 N BROADWAY, SUITE 207, SANTA ANA, CA 92706
(714) 972-0040
Mailing address
P.O. BOX 6299, LAGUNA NIGUEL, CA 92607
(714) 972-0040
(714) 460-2010

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
94023427

Other

Enumeration date
10/13/2017
Last updated
10/13/2017
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