Provider First Line Business Practice Location Address:
UCLA DEPT OF PSYCHOLOGY 2191 FRANZ HL
Provider Second Line Business Practice Location Address:
BOX 951563
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-1563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-206-2827
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2012