| Agility Counseling Llc | |
|
855 Jefferson Ave # 70 Redwood City CA 94063-9992 | |
| (415) 968-9540 | |
| Not Available |
| Full Name | Agility Counseling Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 855 Jefferson Ave # 70, Redwood City, California |
| Authorized Official Name and Position | Hadi Koesnodihardjo (MEMBER) |
| Authorized Official Contact | 4159689540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agility Counseling Llc 855 Jefferson Ave # 70 Redwood City CA 94063-9992 Ph: (415) 968-9540 | Agility Counseling Llc 855 Jefferson Ave # 70 Redwood City CA 94063-9992 Ph: (415) 968-9540 |
| NPI Number | 1013733351 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013733351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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