Organization
BRIDGES TO SELF EMPOWERMENT A MARRIAGE AND FAMILY THERAPIST CORPORATIO
Active
Parent organization
BRIDGES TO SELF EMPOWERMENT
Other names
Alice Petty-Hannum MFT
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIDGES TO SELF EMPOWERMENT
Authorized official
ALICE DEE PETTY-HANNUM MFT (CORPORATION OWNER)
(707) 495-5350
Entity
Organization
Contact information
Practice address
406 CHINN ST, SANTA ROSA, CA 95404-4339
(707) 495-5350
(707) 570-2680
Mailing address
406 CHINN ST, SANTA ROSA, CA 95404-4339
(707) 495-5350
(707) 570-2680
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFC43967
CA
Other
Enumeration date
01/29/2017
Last updated
01/29/2017
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