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Organization
RADIANT BEGINNINGS MARRIAGE CHILD & FAMILY THERAPY
Active
Organization
RADIANT BEGINNINGS MARRIAGE CHILD & FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLORY WALTERS LMFT (OWNER/PROVIDER)
(707) 654-4659
Entity
Organization
Contact information
Practice address
1651 VICKSBURG DR, FAIRFIELD, CA 94533-5166
(707) 654-4659
Mailing address
1651 VICKSBURG DR, FAIRFIELD, CA 94533-5166
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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