MEDICARE: BARTLEY FOLEY MA MFT #48016

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1639233513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARTLEY FOLEY MA MFT #48016

Provider Business Mailing Address
First Line	:	2640 ST GEORGE ST
Second Line	:	#4
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-3328
Country	:	US
Telephone Number	:	213-417-8884
Fax Number	:

Provider Business Practice Location Address
First Line	:	2640 ST GEORGE ST
Second Line	:	#4
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-3328
Country	:	US
Telephone Number	:	213-417-8884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	02/11/2010

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Directions to “ BARTLEY FOLEY MA MFT #48016” Practice Location

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