Doctor Name: | STEPHANIE TOWER |
NPI Number: | 1144634007 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 59595 |
Business Practice Address: | 1800 Gravenstein Hwy N Sebastopol, CA - 954722607 |
Business Phone Number: | 7076349064 |
Business Fax Number: | |
Mailing Address: | 1800 Gravenstein Hwy N, SEBASTOPOL |
State: | CA |
Postal Code: | 954722607 |
Phone Number: | 7076349064 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2014 |
NPI Last Update Date: | 07/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 59595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |