| Therapy Era Licensed Clinical Social Worker Pc | |
|
641 Higuera St Ste 220 San Luis Obispo CA 93401-3548 | |
| (805) 235-5540 | |
| Not Available |
| Full Name | Therapy Era Licensed Clinical Social Worker Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 641 Higuera St Ste 220, San Luis Obispo, California |
| Authorized Official Name and Position | Augusta Gordon (CEO) |
| Authorized Official Contact | 3472557637 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Era Licensed Clinical Social Worker Pc 641 Higuera St Ste 220 San Luis Obispo CA 93401-3548 Ph: (805) 235-5540 | Therapy Era Licensed Clinical Social Worker Pc 641 Higuera St Ste 220 San Luis Obispo CA 93401-3548 Ph: (805) 235-5540 |
| NPI Number | 1053129924 |
|---|---|
| Provider Enumeration Date | 12/24/2024 |
| Last Update Date | 12/24/2024 |
| Certification Date | 12/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053129924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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