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General NPI Number Information
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NPI Number | 1528571692
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Entity Type | Organization
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Legal Business Name | REBECCA MCGRUE LMFT DBA MIND OVER MOOD THERAPY
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 3336 BRADSHAW RD STE 215
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City | SACRAMENTO
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State | CA
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Zip | 95827-2624
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Country | US
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Telephone | 916-862-4984
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Fax |
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Provider Business Mailing Address
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Address Line | 4372 AUBERGINE WAY
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City | MATHER
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State | CA
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Zip | 95655-3039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA MCGRUE
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Credential | LMFT
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Telephone | 916-862-4984
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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 | 102177
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License Number State | CA
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