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General NPI Number Information
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NPI Number | 1043700222
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Entity Type | Organization
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Legal Business Name | MICHAEL PHILLIPS RICE LMFT
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 05/14/2018
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Provider Practice Location Address
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Address Line | 204 W MAIN ST STE 119
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City | GRASS VALLEY
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State | CA
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Zip | 95945-4710
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Country | US
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Telephone | 530-559-4624
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Fax |
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Provider Business Mailing Address
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Address Line | 5470 RENO CORPORATE DR
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City | RENO
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State | NV
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Zip | 89511-2250
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Country | US
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Telephone | 775-657-0293
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MICHAEL RICE
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Credential | LMFT
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Telephone | 530-559-4624
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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 | 85668
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License Number State | CA
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