Individual
CAROL LEE PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1445 W SHAW AVE, FRESNO, CA 93711-3608
(559) 222-9512
Mailing address
1445 W SHAW AVE, FRESNO, CA 93711-3608
(559) 222-9512
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
PSY 9316
CA
Other
Enumeration date
04/28/2009
Last updated
04/28/2009
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