Organization · Type 2 NPI

Bridges To Self Empowerment A Marriage and Family Therapist Corporatio

Community/Behavioral Health Agency · Santa Rosa, CA

NPI number 1336686369 Active

Practice location

406 Chinn St
Santa Rosa, CA 95404-4339

Fax (707) 570-2680

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency Primary	251S00000X	MFC43967 (CA)

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

9 other providers at this address

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NPI record

NPI: 1336686369
Entity type: Organization (Type 2)
Issued: Jan 29, 2017
Last updated: Jan 29, 2017
Status: Active
Subpart: Yes of Bridges To Self Empowerment

Other names

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Alice Petty-Hannum MFT · doing business as

Authorized official

Alice Dee Petty-Hannum, MFT
Corporation Owner
(707) 495-5350

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About NPI 1336686369

Bridges To Self Empowerment A Marriage and Family Therapist Corporatio's National Provider Identifier is 1336686369, issued on Jan 29, 2017. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Santa Rosa, CA. The record was last updated on Jan 29, 2017.