Provider Demographics
NPI:1356976914
Name:GLENDORA FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:GLENDORA FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BECKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:626-665-9174
Mailing Address - Street 1:1340 E ROUTE 66 STE 200I
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-3783
Mailing Address - Country:US
Mailing Address - Phone:626-665-9174
Mailing Address - Fax:
Practice Address - Street 1:1340 E ROUTE 66 STE 200I
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-3783
Practice Address - Country:US
Practice Address - Phone:626-665-9174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty