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General NPI Number Information
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NPI Number | 1164028007
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Entity Type | Organization
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Legal Business Name | MIYOUNG SON MARRIAGE FAMILY THERAPY
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 2967 CARLSBAD BLVD
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City | CARLSBAD
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State | CA
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Zip | 92008-2904
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Country | US
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Telephone | 323-452-1955
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Fax | 619-701-6657
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Provider Business Mailing Address
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Address Line | 2967 CARLSBAD BLVD
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City | CARLSBAD
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State | CA
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Zip | 92008-2904
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Country | US
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Telephone | 323-452-1955
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Fax | 619-701-6657
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Authorized Official
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Title or Position | CEO
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Name | MS. MIYOUNG SON
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Credential | MA
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Telephone | 323-452-1955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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