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General NPI Number Information
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NPI Number | 1740628130
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Entity Type | Individual
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Provider Name | LAURA SHLIEN MFT
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Gender | Female
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 503 4TH ST SUITE B
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City | DAVIS
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State | CA
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Zip | 95616-4185
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Country | US
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Telephone | 530-207-0126
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Fax |
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Provider Business Mailing Address
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Address Line | 34835 COUNTY ROAD 29
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City | WOODLAND
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State | CA
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Zip | 95695-9349
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Country | US
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Telephone | 530-207-0126
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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 | 53343
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License Number State | CA
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