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General NPI Number Information
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NPI Number | 1942955281
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Entity Type | Organization
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Legal Business Name | THE ROAD TO WELLNESS
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 3000 L ST STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95816-5248
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Country | US
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Telephone | 916-359-9823
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Fax |
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Provider Business Mailing Address
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Address Line | 6464 VILLA DR
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City | SACRAMENTO
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State | CA
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Zip | 95842-2426
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Country | US
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Telephone | 916-801-6569
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE FAMILY THERAPIST
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Name | DAWN DENA MEHALAKIS
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Credential | LMFT
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Telephone | 916-801-6569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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