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General NPI Number Information
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NPI Number | 1558895920
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Entity Type | Organization
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Legal Business Name | ABIDE COUNSELING
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 1340 BLUE OAKS BLVD SUITE 200
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City | ROSEVILLE
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State | CA
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Zip | 95678-7035
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Country | US
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Telephone | 916-807-4136
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Fax | 916-200-0450
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Provider Business Mailing Address
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Address Line | 1340 BLUE OAKS BLVD SUITE 200
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City | ROSEVILLE
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State | CA
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Zip | 95678-7035
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Country | US
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Telephone | 916-807-4136
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Fax | 916-200-0450
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AMY D NISTOR
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Credential | LMFT
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Telephone | 916-807-4136
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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 |
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License Number State |
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