# FRESNO FAMILY THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fresno Family Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174016240
- **Authorized official:** DANIEL MOULTRIE LMFT (LMFT)
- **Authorized official phone:** (559) 285-6364

## Contact information

- **Practice address:** 745 E LOCUST AVE STE 106, FRESNO, CA 93720-3000
- **Practice address phone:** (559) 795-5990
- **Mailing address:** 550 W ALLUVIAL AVE STE 108, FRESNO, CA 93711-5857
- **Mailing address phone:** (559) 285-6364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 104484 | CA | Yes |
| 106H00000X | Marriage & Family Therapist | 105969 | CA | — |

## Other

- **Enumeration date:** 06/12/2018
- **Last updated:** 04/14/2021