Healthcare Provider Details

I. General information

NPI: 1629210984
Provider Name (Legal Business Name): BARBARA IRENE DREW MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 BELVEDERE CT
NAPA CA
94559-4141
US

IV. Provider business mailing address

53 BELVEDERE CT
NAPA CA
94559-4141
US

V. Phone/Fax

Practice location:
  • Phone: 707-299-7781
  • Fax:
Mailing address:
  • Phone: 707-299-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT20499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: