Provider Information for 1366634495
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ANDREA JEANINE MCLELLAN LMFT
Sex: Female
NPI: 1366634495
Last Updated: 2012-10-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1366634495 | ||||||||
| Enumeration Date | 2007-08-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 140 E STETSON AVE STE 242 HEMET, CA 92543-7139 United States Phone: 951-925-3839 | Fax: | ||||||||
| Primary Practice Address | 29748 RANCHO CALIFORNIA RD TEMECULA, CA 92591-5286 United States Phone: 951-252-9911 | Fax: | ||||||||
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