Most Relevant Information
Provider Data
| NPI Number: | 1003270505 |
| Provider Name: | MIRIAM RUTH BENJAMINA FEESE LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/11/2016 |
| Last Updated: | 02/03/2022 |
Provider Practice Location
20601 W PAOLI LN
WEIMAR
CA
95736
Practice Location Phone/Fax
| Phone: | 5306374025 |
| Fax: |
Provider Mailing Location
PO BOX 237
WEIMAR
CA
957360237
Provider Mailing Phone/Fax
| Phone: | 5302178057 |
| Fax: |