Provider Demographics
NPI:1366002859
Name:PLAN B MARRIAGE & FAMILY THERAPY PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:PLAN B MARRIAGE & FAMILY THERAPY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-493-0404
Mailing Address - Street 1:255 N D ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1714
Mailing Address - Country:US
Mailing Address - Phone:909-493-0404
Mailing Address - Fax:909-912-8493
Practice Address - Street 1:255 N D ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1714
Practice Address - Country:US
Practice Address - Phone:909-493-0404
Practice Address - Fax:909-912-8493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty