Provider First Line Business Practice Location Address:
405 HILGARD AVE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF LOS ANGELES, CALIFORNIA PSYCHOLOGY DEPT.
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:
201-403-5598
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2009