| Child Therapy Institute Of Marin | |
|
92 Louise Street San Rafael CA 94901 | |
| (415) 456-7724 | |
| Not Available |
| Full Name | Child Therapy Institute Of Marin |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 92 Louise Street, San Rafael, California |
| Authorized Official Name and Position | Brian 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., #8 San Rafael CA 94901 Ph: (415) 456-7724 | Child Therapy Institute Of Marin 92 Louise Street San Rafael CA 94901 Ph: (415) 456-7724 |
| NPI Number | 1265790489 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 04/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265790489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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