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Ryan A. Cheaper, PhD. License # PSY25969 (916) 4695865 drcheperka gmail.com INTAKE QUESTIONNAIRE NAME: SSN: DOB: AGE: ADDRESS: PHONE: Home: Is it ok to leave a phone message? No Yes Cell : is it ok
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Information such as the individual's full name, doctoral degree details, area of expertise, and any relevant professional accomplishments must be reported on Ryan A Cheperka PhD.
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