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General NPI Number Information
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NPI Number | 1194987685
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Entity Type | Organization
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Legal Business Name | AFFIRMATIVE COUNSELING AND THERAPY
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 3443 CAMINO DEL RIO S STE. 202
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City | SAN DIEGO
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State | CA
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Zip | 92108-3903
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Country | US
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Telephone | 619-284-8755
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Fax | 619-563-0240
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Provider Business Mailing Address
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Address Line | 3443 CAMINO DEL RIO S STE. 202
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City | SAN DIEGO
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State | CA
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Zip | 92108-3903
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Country | US
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Telephone | 619-284-8755
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Fax | 619-563-0240
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAMELA J ALEXANDRA
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Credential | MFT
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Telephone | 619-284-8755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | MFC33420
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License Number State | CA
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