Individual
ELISE MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 MACDONALD AVE, RICHMOND, CA 94805-2333
(510) 412-9200
Mailing address
4101 MACDONALD AVE, RICHMOND, CA 94805-2333
(510) 412-9200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
—
—
103T00000X
Psychologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/26/2014
Last updated
08/18/2016
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