Owner
NPI #1841742939 in Santa Monica, California
Provider Information
- NPI Number
- 1841742939
- Entity Type
- Organization
- Organization Name
- Owner
- Primary Specialty
- Marriage & Family Therapist
- Enumeration Date
- Oct 25, 2016
- Last Updated
- Oct 25, 2016
Practice Location
- Address
- 353 12TH ST
- City
- Santa Monica
- State
- California
- ZIP Code
- 90402-2013
- Phone
- (310) 393-0539
Authorized Official
- Name
- SANDRA MICHELSON
- Title
- OWNER
- Phone
- (310) 393-0539
Specialties & Taxonomy Codes
| Specialty |
|---|
| Marriage & Family Therapist |
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