Provider Demographics
NPI:1376816041
Name:OHS, MYNDA DANYEL (MFT)
Entity Type:Individual
Prefix:MRS
First Name:MYNDA
Middle Name:DANYEL
Last Name:OHS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 PLUM LN
Mailing Address - Street 2:114
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4576
Mailing Address - Country:US
Mailing Address - Phone:909-663-7399
Mailing Address - Fax:
Practice Address - Street 1:7916 VIA OBRA CT
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-6310
Practice Address - Country:US
Practice Address - Phone:909-214-5445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist