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General NPI Number Information
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NPI Number | 1245362052
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Entity Type | Organization
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Legal Business Name | JUDI CANTOR MA MFT
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 25350 MAGIC MOUNTAIN PKWY SUITE 170
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City | VALENCIA
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State | CA
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Zip | 91355-1151
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Country | US
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Telephone | 661-260-3114
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Fax | 661-253-3757
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Provider Business Mailing Address
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Address Line | 25350 MAGIC MOUNTAIN PKWY SUITE 170
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City | VALENCIA
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State | CA
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Zip | 91355-1151
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Country | US
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Telephone | 661-260-3114
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Fax | 661-253-3757
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Authorized Official
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Title or Position | MFT
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Name | JUDI CANTOR
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Credential | MA
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Telephone | 661-260-3114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC35006
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License Number State | CA
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