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Organization
MARIN YOUTH THERAPY INC.
Active
Organization
MARIN YOUTH THERAPY INC.
Active
Other names
Marin Youth Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KIERSTEN KOTAKA LMFT (PRESIDENT)
(707) 834-4078
Entity
Organization
Contact information
Practice address
101 MEADOW WAY, SAN GERONIMO, CA 94963
(707) 834-4078
Mailing address
PO BOX 193, SAN GERONIMO, CA 94963-0193
(707) 834-4078
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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