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MRS. JEANNINE LOUISE-WISNIEW COLWELL IMF # 72682

>> Marriage & Family Therapist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1720420136

Individual Registrant:
MRS. JEANNINE LOUISE-WISNIEW COLWELL IMF # 72682
Gender: F
Not Sole Proprietor

Location and contact information for practice:
23981 SHERILTON VALLEY RD  DESCANSO, CA 91916-9740 US
Tel: 619-445-0405  Fax: --

Contact information for business:
23981 SHERILTON VALLEY RD  DESCANSO, CA 91916-9740 US
Tel: 619-445-0405  Fax: --

Registration Information:
NPI: 1720420136
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAIMF # 72682

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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