Individual
JUDY PAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
11092 ANDERSON ST, LOMA LINDA, CA 92350-1706
(909) 557-5555
Mailing address
24876 TAYLOR STREET, LOMA LINDA, CALIFORNIA, CA 92350
(909) 557-5555
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
88169
CA
124Q00000X
Dental Hygienist
Primary
9856
CA
Other
Enumeration date
02/14/2007
Last updated
11/19/2011
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