Provider Demographics
NPI:1457195091
Name:MARIAH VLACH LMFT LLC
Entity type:Organization
Organization Name:MARIAH VLACH LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VLACH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:541-406-0184
Mailing Address - Street 1:745 NW MT WASHINGTON DR STE 307
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1576
Mailing Address - Country:US
Mailing Address - Phone:541-406-0184
Mailing Address - Fax:
Practice Address - Street 1:745 NW MT WASHINGTON DR STE 307
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1576
Practice Address - Country:US
Practice Address - Phone:541-406-0184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty