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1104999051
GEORGIANA S. WARDLE
SAN RAFAEL, CA
NPI
1104999051
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: CA MFT28159)
Enumeration Date
2006-11-16
Last Update Date
2007-07-08
Business Address
MS. GEORGIANA S. WARDLE MFT
555 NORTHGATE DR FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL, CA 94903-3680
Phone number: 415-491-5700
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Mailing Address
MS. GEORGIANA S. WARDLE MFT
652 SAUSALITO BLVD
SAUSALITO, CA 94965-2331
Phone number: 415-332-6246
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