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General NPI Number Information
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NPI Number | 1013310044
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Entity Type | Organization
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Legal Business Name | RETURN WITH FREEDOM
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Dates
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Enumeration Date | 10/05/2014
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Last Update Date | 10/05/2014
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Provider Practice Location Address
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Address Line | 817 W GRAND BLVD
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City | CORONA
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State | CA
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Zip | 92882-3265
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Country | US
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Telephone | 888-634-6999
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Fax | 888-634-6999
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Provider Business Mailing Address
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Address Line | 817 W GRAND BLVD
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City | CORONA
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State | CA
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Zip | 92882-3265
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Country | US
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Telephone | 888-634-6999
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Fax | 888-634-6999
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARLA JOY MAYNARD
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Credential | LMFT
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Telephone | 888-634-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT46876
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License Number State | CA
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