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General NPI Number Information
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NPI Number | 1629505029
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Entity Type | Individual
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Provider Name | STEVEN WESLEY HENRY MFT
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Gender | Male
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 05/16/2017
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Provider Practice Location Address
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Address Line | 260 MAPLE CT STE 103
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City | VENTURA
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State | CA
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Zip | 93003-3553
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Country | US
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Telephone | 805-267-0881
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Fax | 818-981-0649
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Provider Business Mailing Address
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Address Line | 4621 VIA ACIANDO
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City | CAMARILLO
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State | CA
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Zip | 93012-4047
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Country | US
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Telephone | 805-312-0569
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MFT17367
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License Number State | CA
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