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NPI Code Detail

MEDICARE: CARLY DOSH LCSW

MEDICARE:   CARLY  DOSH  LCSW
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
11041C0700XClinical Social Worker83133CA

General Provider Information

NPI Number : 1942856158
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY DOSH LCSW
Provider Business Mailing Address
First Line : 1308 E COLORADO BLVD # 2397
Second Line :
City : PASADENA
State : CA
Zip : 91106-1932
Country : US
Telephone Number : 626-214-5101
Fax Number :
Provider Business Practice Location Address
First Line : 1308 E COLORADO BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91106-1932
Country : US
Telephone Number : 626-214-5101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2019
Last Update Date : 10/01/2024

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Directions to “ CARLY DOSH LCSW” Practice Location

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