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General NPI Number Information
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NPI Number | 1407362247
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Entity Type | Organization
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Legal Business Name | GRAHAM DELIS MARRIAGE & FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 12/15/2017
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Provider Practice Location Address
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Address Line | 5301 OFFICE PARK DR STE 225
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0666
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Country | US
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Telephone | 661-201-1449
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Fax | 661-748-1878
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Provider Business Mailing Address
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Address Line | 5301 OFFICE PARK DR STE 225
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0666
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Country | US
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Telephone | 661-201-1449
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Fax | 661-748-1878
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | HOLLY AMANDA GRAHAM
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Credential | LMFT
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Telephone | 661-201-1449
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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 | LMFT48934
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT46684
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License Number State | CA
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