Most Relevant Information
Provider Data
| NPI Number: | 1003057860 |
| Provider Name: | MARY LOU MIED PH.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | PSY 21629 |
Most Important Dates
| Enumeration Date: | 03/09/2009 |
| Last Updated: | 05/17/2010 |
Provider Practice Location
919 VILLAGE CTR
#9
LAFAYETTE
CA
945493598
Practice Location Phone/Fax
| Phone: | 9259420834 |
| Fax: | 9259420837 |
Provider Mailing Location
PO BOX 472
LAFAYETTE
CA
945490472
Provider Mailing Phone/Fax
| Phone: | 9259420834 |
| Fax: | 9259420837 |