Doctor Name: | MS. ANAHITA ANDREA DE CLEYRE |
NPI Number: | 1043580574 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MFT-I |
License Number: | IMF 68105 |
Business Practice Address: | 1450 Main St. Weaverville, CA - 96093 |
Business Phone Number: | 5306231362 |
Business Fax Number: | 5306231447 |
Mailing Address: | Po Box 1640, WEAVERVILLE |
State: | CA |
Postal Code: | 960931640 |
Phone Number: | 5306231362 |
Fax Number: | 5306231447 |
NPI Enumeration Date: | 12/30/2011 |
NPI Last Update Date: | 12/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | IMF 68105 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |