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General NPI Number Information
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NPI Number | 1114195716
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Entity Type | Individual
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Provider Name | DEZAREE ANN FINCH MFCT TRAINEE
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Gender | Female
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 255 N LINCOLN ST A
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City | DIXON
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State | CA
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Zip | 95620-3238
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Country | US
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Telephone | 707-631-1733
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Fax |
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Provider Business Mailing Address
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Address Line | 908 GREGORY PL
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City | DAVIS
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State | CA
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Zip | 95616-2522
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Country | US
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Telephone | 530-845-1678
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State |
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