Provider Demographics
NPI:1417314733
Name:DORIS A MUCHIRAHODO
Entity Type:Organization
Organization Name:DORIS A MUCHIRAHODO
Other - Org Name:LET TALK THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARRIAGE & FAMILY THERAPIST INTERN
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUCHIRAHONDO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:949-813-5222
Mailing Address - Street 1:182 VIA SERENA
Mailing Address - Street 2:
Mailing Address - City:RSM
Mailing Address - State:CA
Mailing Address - Zip Code:92688-1728
Mailing Address - Country:US
Mailing Address - Phone:949-813-5222
Mailing Address - Fax:
Practice Address - Street 1:182 VIA SERENA
Practice Address - Street 2:
Practice Address - City:RSM
Practice Address - State:CA
Practice Address - Zip Code:92688-1728
Practice Address - Country:US
Practice Address - Phone:949-813-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90294251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health