Healthcare Provider Details
I. General information
NPI: 1245364322
Provider Name (Legal Business Name): ARELLA LYDIA KARSPECK M.F.T.I.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12450 VAN NUYS BLVD SUITE 100
PACOIMA CA
91331-1391
US
IV. Provider business mailing address
512 S EUCLID AVE UNIT # 6
PASADENA CA
91101-3264
US
V. Phone/Fax
- Phone: 818-896-8366
- Fax: 818-896-8392
- Phone: 626-354-2584
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: