Individual provider · Type 1 NPI

Madedeh Alfogbanah

Mental Health Counselor · Petaluma, CA

NPI number 1164573135 Active

Practice location

1516 Wase Madison Street
Petaluma, CA 94954

Call (707) 541-9926 Map

Mailing address

1516 E Madison St
Petaluma, CA 94954-2319

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1164573135

Madedeh Alfogbanah's National Provider Identifier is 1164573135, issued on Jan 16, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Petaluma, CA. The record was last updated on Jul 8, 2007.