1497852008 NPI number — REDDING FIRE DISTRICT NO 1

Table of content: MICHELLE MUNYAN MA LPC (NPI 1639299860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497852008 NPI number — REDDING FIRE DISTRICT NO 1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REDDING FIRE DISTRICT NO 1
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497852008
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1151
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDDING
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06875
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-797-9601
Provider Business Mailing Address Fax Number:
203-791-1756

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
186 LACK ROCK TURNPIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06875
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-797-9601
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GRILLO-HARDEN
Authorized Official First Name:
DANIELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
860-638-1800

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)