Silver Fiddle Therapy

Organization Active NPI Marriage & Family Therapist · Pine Grove, CA

NPI 1639739121 · NPPES record last updated Jun 17, 2019

Key facts

NPI
1639739121
Entity type
Organization (NPI type 2)
Primary specialty
Marriage & Family Therapist 106H00000X
Legal business name
SILVER FIDDLE THERAPY
Practice address
19881 State Highway 88
Pine Grove, CA 95665-9495
Phone
(209) 560-6012
NPI assigned
Jun 17, 2019
Organization subpart
No

Authorized official

Name
Ms. Lola Marie Blevins, LMFT
Title
President
Phone
(209) 304-8821

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

19881 State Highway 88
Pine Grove, CA 95665
Phone (209) 560-6012

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
106H00000X Yes

Addresses

Primary practice location

19881 State Highway 88
Pine Grove, CA 95665-9495

Mailing address

PO Box 182
Volcano, CA 95689-0182
Phone (209) 304-8821

Other practice location 1

24521 Shake Ridge Rd
Volcano, CA 95689-9629
Phone (209) 560-6012

Other providers in Pine Grove, CA

All providers in Pine Grove, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.