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Individual

ERIKA LYNN MALSOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MFT-INTERN

Contact information

Practice address
137 E OAK STREET, FORT BRAGG, CA 95437
(707) 961-0172
(844) 388-6167
Mailing address
PO BOX 2168, MENDOCINO COAST HOSPITALITY CENTER, FORT BRAGG, CA 95437
(707) 961-0172
(844) 388-6167

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
225C00000X
Rehabilitation Counselor
92589
CA
251S00000X
Community/Behavioral Health Agency
Primary
MFC41677
CA

Other

Enumeration date
05/13/2014
Last updated
06/05/2019
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