Organization
FAMILY DYNAMICS RESOURCE CENTER
Active
Organization
FAMILY DYNAMICS RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA ANN WILSON MA, LMFT (EXECUTIVE DIRECTOR)
(530) 605-9902
Entity
Organization
Contact information
Practice address
3657 RICARDO AVE, REDDING, CA 96002-2627
(530) 242-9007
Mailing address
3657 RICARDO AVE, REDDING, CA 96002-2627
(530) 242-9007
(530) 223-2027
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
49910
CA
251S00000X
Community/Behavioral Health Agency
LCS22115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023168259
1 INDIVIDUAL
CA
01
—
1619272564
FAMILY DYNAMICS RESOURCE CENTER
CA
01
—
1942221130
1-INDIVIDUAL
CA
Enumeration date
01/24/2011
Last updated
08/06/2013
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