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General NPI Number Information
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NPI Number | 1225639495
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Entity Type | Organization
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Legal Business Name | BRINGING MEDICINE CULTURALLY COMPETENT COUNSELING AND INDIGENOUS
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 206 SACRAMENTO ST SUITE 212
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City | NEVADA
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State | CA
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Zip | 95959
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Country | US
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Telephone | 530-307-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 210 ELYSIAN PLACE
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City | GRASS VALLEY
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State | CA
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Zip | 95945
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Country | US
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Telephone | 530-307-0101
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Fax |
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | DR. TONYA E ELLIOTT
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Credential | PHD LMFT
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Telephone | 530-307-0101
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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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