person
Edgar Carl De Van Iv, MFTINTERN/TRAINEE
Mental Health Counselor in San Rafael, California
NPI 1578756599

Edgar Carl De Van Iv is a Mental Health Counselor based in San Rafael, CA and is specialized in Mental Health. Edgar Carl De Van Iv practices in San Rafael, CA and has the professional credentials of MFTINTERN/TRAINEE. The NPI Number for Edgar Carl De Van Iv is 1578756599 and holds a License No. (California).

The current practice location address for Edgar Carl De Van Iv is 555 Northgate Dr, San Rafael, CA and can be reached out via phone at 415-491-5700 and via fax at 415-491-5750.

Location: 555 Northgate Dr, San Rafael, CA, 94903-3680
person
Provider Profile Details
NPI Number
1578756599
Provider Name
Edgar Carl De Van Iv
Credential
MFTINTERN/TRAINEE
Provider Entity Type
Individual
Gender
Male
Address
555 Northgate Dr, San Rafael, CA, 94903-3680
Phone Number
415-491-5700
Fax Number
415-491-5750
Provider Enumeration Date
08/22/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
555 Northgate Dr
City
State
Zip
94903-3680
Phone Number
415-491-5700
Fax Number
415-491-5750
person
Provider Business Mailing Address Details
Address
555 Northgate Dr
City
State
Zip
94903-3680
Phone Number
415-491-5700
Fax Number
415-491-5750
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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