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General NPI Number Information
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NPI Number | 1124568233
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Entity Type | Organization
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Legal Business Name | SLEA
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 10285 TUJUNGA CANYON BLVD 109
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City | TUJUNGA
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State | CA
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Zip | 91042-2253
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Country | US
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Telephone | 818-307-2132
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Fax |
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Provider Business Mailing Address
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Address Line | 10285 TUJUNGA CANYON BLVD 109
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City | TUJUNGA
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State | CA
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Zip | 91042-2253
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Country | US
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Telephone | 818-307-2132
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Fax |
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Authorized Official
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Title or Position | BEHAVIORAL THERAPIST
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Name | ARMINE JANJIKYAN
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Credential | DL
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Telephone | 818-307-2132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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