| Nicole Goolsby, Licensed Marriage And Family Therapist, Inc. | |
|
219 N Indian Hill Blvd Ste 102 Claremont CA 91711-4644 | |
| (909) 206-4453 | |
| Not Available |
| Full Name | Nicole Goolsby, Licensed Marriage And Family Therapist, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 219 N Indian Hill Blvd Ste 102, Claremont, California |
| Authorized Official Name and Position | Nicole Goolsby (LMFT/OWNER) |
| Authorized Official Contact | 9092064453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Goolsby, Licensed Marriage And Family Therapist, Inc. Po Box 9266 Rancho Cucamonga CA 91701-8266 Ph: (909) 206-4453 | Nicole Goolsby, Licensed Marriage And Family Therapist, Inc. 219 N Indian Hill Blvd Ste 102 Claremont CA 91711-4644 Ph: (909) 206-4453 |
| NPI Number | 1760941199 |
|---|---|
| Provider Enumeration Date | 03/15/2019 |
| Last Update Date | 05/21/2020 |
| Certification Date | 05/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760941199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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