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General NPI Number Information
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NPI Number | 1457721201
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Entity Type | Organization
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Legal Business Name | SHARLENE SPEIGHTS
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 191 VISTA WAY
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City | MARTINEZ
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State | CA
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Zip | 94553-4051
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Country | US
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Telephone | 925-708-3143
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Fax | 925-370-7817
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Provider Business Mailing Address
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Address Line | 191 VISTA WAY
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City | MARTINEZ
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State | CA
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Zip | 94553-4051
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Country | US
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Telephone | 925-708-3143
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Fax | 925-370-7817
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Authorized Official
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Title or Position | MARRIAGE FAMILY THERAPIST
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Name | MS. SHARLENE RUTH SPEIGHTS
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Credential | M.F.T.
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Telephone | 925-708-3143
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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 | M15652
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License Number State | CA
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