| Child Therapy Institute Of Marin | |
|
720 Southpoint Blvd Petaluma CA 94954-7495 | |
| (707) 237-3644 | |
| Not Available |
| Full Name | Child Therapy Institute Of Marin |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 720 Southpoint Blvd, Petaluma, California |
| Authorized Official Name and Position | Brian N Lukas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4154567724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Therapy Institute Of Marin 1480 Lincoln Ave Ste 8 San Rafael CA 94901-2085 Ph: () - | Child Therapy Institute Of Marin 720 Southpoint Blvd Petaluma CA 94954-7495 Ph: (707) 237-3644 |
| NPI Number | 1154713774 |
|---|---|
| Provider Enumeration Date | 02/19/2015 |
| Last Update Date | 02/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154713774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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