Connolly, Medria Lou

Connolly, Medria Lou is an individual health care provider with primary practice located at 2444 Wilshire Blvd Suite 500, Santa Monica CA 90403-5808. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Connolly, Medria Lou can be contacted via phone (310) 264-2602.

Contact Information

Primary practice address
2444 Wilshire Blvd Suite 500 Santa Monica CA 90403-5808
Phone: (310) 264-2602
Fax: (310) 264-2601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY9977 California
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY9977 California
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY9977 California

Profile Details

NPI number 1164540316
LBN Legal business name Connolly, Medria Lou
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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