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TRACEY R IMSLAND M. ED. AND LEP

School >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1588337281

Individual Registrant:
 TRACEY R IMSLAND M. ED. AND LEP
Gender: F
Sole Proprietor

Location and contact information for practice:
1150 SANDALWOOD DR  MURPHYS, CA 95247-9666 US
Tel: 949-633-7071  Fax: --

Contact information for business:
PO BOX 806  MURPHYS, CA 95247-0806 US
Tel: 949-633-7071  Fax: --

Registration Information:
NPI: 1588337281
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TS0200XBehavioral Health & Social Service Providers
Psychologist
School
CA2653

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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