Basic Information
| Provider Information | |||||||||
| NPI: | 1881780625 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRAEL | ||||||||
| FirstName: | TRESSA | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1376 | ||||||||
| Address2: | |||||||||
| City: | NORTH FORK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936431376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5598773305 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3133 N MILLBROOK AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937031425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594538918 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC 23524 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.