| The Bodhi Tree, A Licensed Clinical Social Worker Corp | |
|
7355 Church St Ste A Yucca Valley CA 92284-3273 | |
| (760) 517-3377 | |
| (760) 517-3377 |
| Full Name | The Bodhi Tree, A Licensed Clinical Social Worker Corp |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7355 Church St Ste A, Yucca Valley, California |
| Authorized Official Name and Position | Brad K Nyman (PRESIDENT/LEAD THERAPIST) |
| Authorized Official Contact | 9492948627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bodhi Tree, A Licensed Clinical Social Worker Corp 7355 Church St Ste A Yucca Valley CA 92284-3273 Ph: (760) 517-3377 | The Bodhi Tree, A Licensed Clinical Social Worker Corp 7355 Church St Ste A Yucca Valley CA 92284-3273 Ph: (760) 517-3377 |
| NPI Number | 1831894963 |
|---|---|
| Provider Enumeration Date | 03/30/2023 |
| Last Update Date | 03/30/2023 |
| Certification Date | 03/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831894963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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