Individual
DR. LAURA LYNN MANSOURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1260 LAKE BLVD STE 217, DAVIS, CA 95616-5667
(530) 848-3377
Mailing address
1260 LAKE BLVD STE 217, DAVIS, CA 95616-5667
(530) 848-3377
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY15316
CA
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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