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General NPI Number Information
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NPI Number | 1457971178
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Entity Type | Organization
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Legal Business Name | BARBARA ISRAELS, MARRIAGE FAMILY THERAPIST, INC.
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 3300 TULLY RD STE C1
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City | MODESTO
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State | CA
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Zip | 95350-0849
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Country | US
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Telephone | 209-522-4164
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Fax | 209-529-2282
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Provider Business Mailing Address
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Address Line | 3300 TULLY RD STE C1
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City | MODESTO
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State | CA
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Zip | 95350-0849
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Country | US
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Telephone | 209-522-4164
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Fax | 209-529-2282
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARBARA ISRAELS
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Credential |
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Telephone | 209-522-4164
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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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