Convergent Brain Diagnostics
NPI #1902550445 in El Dorado Hills, California
Provider Information
- NPI Number
- 1902550445
- Entity Type
- Organization
- Organization Name
- Convergent Brain Diagnostics
- Primary Specialty
- Marriage & Family Therapist
- Enumeration Date
- Feb 3, 2022
- Last Updated
- Feb 3, 2022
Practice Location
- Address
- 4359 TOWN CENTER BLVD STE 217
- City
- El Dorado Hills
- State
- California
- ZIP Code
- 95762-7113
- Phone
- (916) 836-0036
Authorized Official
- Name
- MRS. MARYJO BROOKS-MOTL, LMFT
- Title
- VICE PRESIDENT/CLINICAL DIRECTOR
- Phone
- (916) 836-0036
Specialties & Taxonomy Codes
| Specialty |
|---|
| Marriage & Family Therapist |
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