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General NPI Number Information
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NPI Number | 1376134569
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Entity Type | Organization
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Legal Business Name | ONYX COUNSELING AND TRAUMA FAMILY THERAPY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 619 N IRWIN ST
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City | HANFORD
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State | CA
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Zip | 93230-3825
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Country | US
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Telephone | 559-772-4677
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 SHORT DR
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City | HANFORD
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State | CA
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Zip | 93230-1749
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Country | US
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Telephone | 559-816-5760
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | KATHERINE BAKER
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Credential | LMFT
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Telephone | 559-772-4677
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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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