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Psychological Sunrise Center, LLC Dr. Dina Racer, Pay. D. Licensed Clinical Psychologist (480) 5633587 www.psychologicalsunrisecenter.com CHILD INTAKE FORM Child's name: Today's Date: Birth date:
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Psychological Sunrise Center PLLC is a mental health center that offers psychological services and therapy.
Psychological Sunrise Center PLLC is required to be filed by the owners or operators of the mental health center.
To fill out Psychological Sunrise Center PLLC, the owners or operators need to provide information about the center's services, staff, financial information, and any other relevant details.
The purpose of Psychological Sunrise Center PLLC is to provide mental health services and therapy to individuals in need.
The information that must be reported on Psychological Sunrise Center PLLC includes the center's services offered, staff qualifications, financial information, and any other relevant details.
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