Basic Information
Provider Information
NPI: 1871801472
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIER
FirstName: CAROLYNN
MiddleName: JEANINE
NamePrefix: MISS
NameSuffix:  
Credential: M.A., IMF
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1801
Address2:  
City: SAN MATEO
State: CA
PostalCode: 944010934
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 609 PRICE AVE
Address2:  
City: REDWOOD CITY
State: CA
PostalCode: 940631463
CountryCode: US
TelephoneNumber: 6503668436
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/16/2010
LastUpdateDate: 09/16/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XIMF60792CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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