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General NPI Number Information
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NPI Number | 1306551312
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Entity Type | Organization
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Legal Business Name | SOUND MIND NEUROFEEDBACK & HEALING CENTER: A MARRIAGE & FAMILY THERAPY
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 08/31/2024
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Provider Practice Location Address
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Address Line | 3128 O ST STE 3
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City | SACRAMENTO
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State | CA
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Zip | 95816-6545
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Country | US
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Telephone | 415-484-9894
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Fax |
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Provider Business Mailing Address
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Address Line | 6650 FAIR OAKS BLVD # 122
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City | CARMICHAEL
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State | CA
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Zip | 95608-4026
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Country | US
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Telephone | 415-484-9894
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BONNIE CARDELL
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Credential | LMFT
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Telephone | 415-484-9894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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