Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY19346 | CA |
N | 103TC0700X | Clinical Psychologist | PSY19346 | CA |
N | 103G00000X | Clinical Psychologist | PSY19346 | CA |
N | 103TC0700X | Clinical Psychologist | PSY19346 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY19346 | CA |
NPI | 1477628923 |
---|---|
Provider Name | Margaret Mary Slaven |
First Address | Fullerton, CA 92835-4126 |
Second Address | Fullerton, CA 92835-4126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 08/07/2007 |