Organization Name: | MILL VALLEY PERFORMANCE CONSULTING GROUP, INC. |
NPI Number: | 1124176615 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHLEEN MARY TERESA JAROSZ (CEO) |
Mailing Address: | 300 Tamal Plz Ste 140 Corte Madera |
State: | CA US |
Postal Code: | 949251131 |
Phone Number: | 4154829796 |
Fax Number: | 4154829796 |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 05/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LCS14376 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |