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General NPI Number Information
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NPI Number | 1467585208
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Entity Type | Individual
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Provider Name | ELLEN GIBB SPECHT PHD
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2830 G ST SUITE D
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City | EUREKA
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State | CA
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Zip | 95501-4446
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Country | US
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Telephone | 707-444-8355
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Fax | 707-444-8355
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Provider Business Mailing Address
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Address Line | 4055 HILLSIDE CT
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City | EUREKA
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State | CA
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Zip | 95503-1304
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Country | US
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Telephone | 707-443-6460
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Fax | 707-444-8355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MFT 30827
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License Number State | CA
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