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KATHRYN C REISIG MFT

>> Marriage & Family Therapist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1578719134

Individual Registrant:
 KATHRYN C REISIG MFT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
9860 MIDDLE CREEK RD  UPPER LAKE, CA 95485-9265 US
Tel: 707-275-8166  Fax: --

Contact information for business:
1616 SIR FRANCIS DRAKE BLVD APT D  SAN ANSELMO, CA 94960-1872 US
Tel: 415-342-0882  Fax: --

Registration Information:
NPI: 1578719134
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAMFC 41169

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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