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Organization
BUCHANAN TRAUMA RECOVERY FAMILY THERAPY
Active
Organization
BUCHANAN TRAUMA RECOVERY FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILESE BUCHANAN MS (OWNER/LMFT)
(951) 344-6428
Entity
Organization
Contact information
Practice address
1410 3RD ST STE 12, RIVERSIDE, CA 92507-3422
(951) 344-6428
Mailing address
PO BOX 52015, RIVERSIDE, CA 92517-3015
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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