DR. Mary J Lague, PSYCHOLOGIST PSY D
NPI #1215962592 in Santa Rosa, California
Provider Information
- NPI Number
- 1215962592
- Entity Type
- Individual
- Name
- DR. Mary J Lague, PSYCHOLOGIST PSY D
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Psychologist - Clinical
- Credential
- PSYCHOLOGIST PSY D
- Enumeration Date
- Jul 12, 2006
- Last Updated
- Dec 30, 2021
Practice Location
- Address
- 403 CHINN ST
- City
- Santa Rosa
- State
- California
- ZIP Code
- 95404-4338
- Phone
- (707) 575-9522
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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