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NPI Code Detail

MEDICARE: AMIE LOWERY LUYTIES INC

MEDICARE: AMIE LOWERY LUYTIES INC
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
1101YM0800XMental Health Counselor41428CA

General Provider Information

NPI Number : 1942608781
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMIE LOWERY LUYTIES INC
Provider Business Mailing Address
First Line : 600 E OCEAN BLVD STE 400B
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-5013
Country : US
Telephone Number : 562-310-9741
Fax Number : 888-746-6008
Provider Business Practice Location Address
First Line : 600 E OCEAN BLVD STE 400B
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-5013
Country : US
Telephone Number : 562-310-9741
Fax Number : 888-746-6008
Authorized Official
Title or Position : OWNER
Name : AMIE LOWERY LUYTIES
Credential : MFT
Telephone Number : 562-310-9741
Provider Enumeration Date : 12/10/2014
Last Update Date : 12/10/2014

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