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General NPI Number Information
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NPI Number | 1538692355
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Entity Type | Organization
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Legal Business Name | MICHELE CYR, LCSW
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Dates
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Enumeration Date | 04/08/2017
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Last Update Date | 04/08/2017
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Provider Practice Location Address
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Address Line | 4199 FLAT ROCK DR #105
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City | RIVERSIDE
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State | CA
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Zip | 92505-7115
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Country | US
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Telephone | 951-970-0372
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Fax | 951-710-9567
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Provider Business Mailing Address
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Address Line | 4199 FLAT ROCK DR #105
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City | RIVERSIDE
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State | CA
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Zip | 92505-7115
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Country | US
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Telephone | 951-970-0372
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Fax | 951-710-9567
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MICHELE CYR
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Credential | LCSW
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Telephone | 951-970-0372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS16724
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License Number State | CA
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