Individual
MRS. AMY DELENE NISTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1340 BLUE OAKS BLVD, SUITE 200, ROSEVILLE, CA 95678-7035
(916) 807-4136
Mailing address
PO BOX 1713, LOOMIS, CA 95650-1713
(916) 807-4136
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
94544
CA
Other
Enumeration date
07/09/2012
Last updated
08/24/2016
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