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General NPI Number Information
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NPI Number | 1558133405
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Entity Type | Organization
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Legal Business Name | RESTWARD: A MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 2108 N ST # 6710
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 310-896-8624
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 N ST # 6710
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 310-896-8624
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTINE ARCHER
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Credential | LMFT, APCC
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Telephone | 310-896-8624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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