Provider Demographics
NPI:1700100203
Name:DRAHEIM, BARBARA J (PHD MFT MFC)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:J
Last Name:DRAHEIM
Suffix:
Gender:F
Credentials:PHD MFT MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 6274
Mailing Address - Street 2:
Mailing Address - City:TAHOE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96145
Mailing Address - Country:US
Mailing Address - Phone:775-831-7204
Mailing Address - Fax:775-831-1777
Practice Address - Street 1:3080 NORTH LAKE BLVD.
Practice Address - Street 2:
Practice Address - City:TAHOE CITY
Practice Address - State:CA
Practice Address - Zip Code:96145
Practice Address - Country:US
Practice Address - Phone:775-831-7204
Practice Address - Fax:775-831-1777
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMFT-0316102L00000X
CAMFC-26046102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst