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General NPI Number Information
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NPI Number | 1992909089
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Entity Type | Individual
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Provider Name | MARGARET ELLEN CLARSTROM MFT
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Gender | Female
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 935 3RD ST
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City | EUREKA
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State | CA
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Zip | 95501-0513
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Country | US
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Telephone | 707-444-8895
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Fax | 707-444-0220
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Provider Business Mailing Address
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Address Line | 1670 WILD CANARY ST
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City | MCKINLEYVILLE
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State | CA
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Zip | 95519-4076
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Country | US
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Telephone | 707-840-0931
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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 | MFC42423
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License Number State | CA
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