| Wonderfully Human Marriage And Family Therapy, Inc. | |
|
20786 Bear Valley Rd Ste I Apple Valley CA 92308-6909 | |
| (805) 285-2696 | |
| Not Available |
| Full Name | Wonderfully Human Marriage And Family Therapy, Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 20786 Bear Valley Rd Ste I, Apple Valley, California |
| Authorized Official Name and Position | Andrew Rudd (OWNER) |
| Authorized Official Contact | 8052852696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wonderfully Human Marriage And Family Therapy, Inc. 16040 Greyrock St Victorville CA 92395-8628 Ph: (909) 560-1934 | Wonderfully Human Marriage And Family Therapy, Inc. 20786 Bear Valley Rd Ste I Apple Valley CA 92308-6909 Ph: (805) 285-2696 |
| NPI Number | 1063274496 |
|---|---|
| Provider Enumeration Date | 01/30/2024 |
| Last Update Date | 01/30/2024 |
| Certification Date | 01/30/2024 |
| Medicare PECOS PAC ID | 4082053095 |
|---|---|
| Medicare Enrollment ID | O20240423002259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063274496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Andrew S Rudd |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1417414749 PECOS PAC ID: 1254770266 Enrollment ID: I20240501002409 |
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