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Organization
CHILD THERAPY INSTITUTE OF MARIN
Active
Organization
CHILD THERAPY INSTITUTE OF MARIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERIE SHUGHART (ADMINISTRATIVE ASSISTANT)
(415) 456-7724
Entity
Organization
Contact information
Practice address
558 SAN ANSELMO AVE, SAN ANSELMO, CA 94960-2621
(415) 456-7724
(415) 456-1050
Mailing address
1480 LINCOLN AVE STE 8, SAN RAFAEL, CA 94901-2085
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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