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General NPI Number Information
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NPI Number | 1245079276
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Entity Type | Individual
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Provider Name | LUCY DREW
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Gender | Female
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 200 E DEL MAR BLVD
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City | PASADENA
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State | CA
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Zip | 91105-2544
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Country | US
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Telephone | 310-400-6460
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36308
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City | LOS ANGELES
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State | CA
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Zip | 90036-0308
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Country | US
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Telephone | 317-292-6067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 146823
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 146823
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License Number State | CA
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