Healthcare Provider Details

I. General information

NPI: 1932722345
Provider Name (Legal Business Name): IZMIRIAN COUNSELING, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10819 NE 99TH AVE
VANCOUVER WA
98662-3439
US

IV. Provider business mailing address

10819 NE 99TH AVE
VANCOUVER WA
98662-3439
US

V. Phone/Fax

Practice location:
  • Phone: 818-437-4232
  • Fax:
Mailing address:
  • Phone: 818-437-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELA ALICE IZMIRIAN
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 818-437-4232