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1780090571
CAROLYN DETIERRA
SANTA ROSA, CA
NPI
1780090571
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 45053)
Enumeration Date
2014-07-01
Last Update Date
2022-05-19
Business Address
CAROLYN DETIERRA MFT
480 TESCONI CIR STE B
SANTA ROSA, CA 95401-4691
Phone number: 707-583-1456
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Mailing Address
CAROLYN DETIERRA MFT
1958 ALAMO LN
SANTA ROSA, CA 95407-8908
Phone number: 707-888-7519
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