Child Therapy Institute Of Marin

NPI 1154713774 - Clinic/Center - 261QM0801X

NPI Details
NPI 1154713774
Enumeration Date 02/19/2015
Last Updated 02/19/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name BRIAN N BRIAN
Position EXECUTIVE DIRECTOR
Phone (707) 237-3644
Fax
Practice Location
720 SOUTHPOINT BLVD
PETALUMA CA, 94954-7495, US
Phone (707) 237-3644
Fax
Business Location
1480 LINCOLN AVE STE 8
SAN RAFAEL CA, 94901-2085, US
Phone
Fax
Toxanomy
Taxonomy Code 261QM0801X
License State
License Number
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According to our database, Child Therapy Institute Of Marin NPI is 1154713774, taxonomy code is 261QM0801X Child Therapy Institute Of Marin physically located at 720 Southpoint Blvd, Petaluma CA, 94954-7495. NPI Number 1033115704 has the healthcare provider type.

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1154713774 NPI number is provided on an as is basis without warranty of any kind. 1154713774 is maintained by the National Plan & Provider Enumeration System. The contents of Child Therapy Institute Of Marin are for informational purposes only.