Basic Information
| Provider Information | |||||||||
| NPI: | 1639402613 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | FRANCES | ||||||||
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| Credential: | MA, MFT INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 WOODHUE CT | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940623239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503695222 | ||||||||
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| Practice Location | |||||||||
| Address1: | 610 ELM ST STE 212 | ||||||||
| Address2: | |||||||||
| City: | SAN CARLOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940703070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505919623 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2009 | ||||||||
| LastUpdateDate: | 09/09/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | IMF 60674 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.