Individual
MS. ALICIA NOURSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
633 CHERRY ST, SANTA ROSA, CA 95404-4202
(707) 526-0300
Mailing address
PO BOX 1074, OCCIDENTAL, CA 95465-1074
(707) 526-0300
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC 39786
CA
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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