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NPI Code Detail

MEDICARE: MARY DENISE HINSDALE LMFT

MEDICARE:   MARY DENISE HINSDALE  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistM15347CA

General Provider Information

NPI Number : 1457999781
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY DENISE HINSDALE LMFT
Provider Business Mailing Address
First Line : 120 PLEASANT HILL AVE N STE 370
Second Line :
City : SEBASTOPOL
State : CA
Zip : 95472-3169
Country : US
Telephone Number : 707-595-3487
Fax Number :
Provider Business Practice Location Address
First Line : 120 PLEASANT HILL AVE N STE 370
Second Line :
City : SEBASTOPOL
State : CA
Zip : 95472-3169
Country : US
Telephone Number : 707-595-3487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2019
Last Update Date : 12/17/2019

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Directions to “ MARY DENISE HINSDALE LMFT” Practice Location

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