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General NPI Number Information
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NPI Number | 1538650544
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Entity Type | Organization
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Legal Business Name | KORDIC MARRIAGE & FAMILY COUNSELING PROF. CORP.
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 2386 BRIARWOOD CIR
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City | EUREKA
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State | CA
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Zip | 95503-7500
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Country | US
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Telephone | 707-298-9801
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Fax |
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Provider Business Mailing Address
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Address Line | 2386 BRIARWOOD CIR
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City | EUREKA
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State | CA
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Zip | 95503-7500
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Country | US
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Telephone | 707-298-9801
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KAIA M KORDIC
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Credential | LMFT
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Telephone | 707-298-9801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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