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General NPI Number Information
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NPI Number | 1194919845
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Entity Type | Individual
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Provider Name | ELAINE GERRY ABRAMS MFT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 403 CHINN ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-4338
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Country | US
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Telephone | 707-578-6444
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Fax |
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Provider Business Mailing Address
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Address Line | 5540 MULBERRY DR
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City | SANTA ROSA
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State | CA
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Zip | 95409-3833
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Country | US
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Telephone | 707-538-7203
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Fax | 707-538-0706
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MEC28231
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License Number State | CA
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