Gottfried, Desiree Michelle

Gottfried, Desiree Michelle is an sole proprietor health care provider with primary practice located at 1627 S Hargrave St , Banning CA 92220-6169. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Gottfried, Desiree Michelle can be contacted via phone (951) 922-7612.

Contact Information

Primary practice address
1627 S Hargrave St Banning CA 92220-6169
Phone: (951) 922-7612
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 114843 California

Profile Details

NPI number 1053663930
LBN Legal business name Gottfried, Desiree Michelle
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2012
Last updated Apr 12th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053663930 NPPES
California Other 114843 BOARD OF BEHAVIORAL SCIENCES

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