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General NPI Number Information
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NPI Number | 1275848459
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Entity Type | Organization
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Legal Business Name | ANXIETY THERAPY LA
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 16055 VENTURA BLVD STE 1020
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City | ENCINO
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State | CA
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Zip | 91436-2611
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Country | US
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Telephone | 310-592-0597
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Fax |
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Provider Business Mailing Address
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Address Line | 16055 VENTURA BLVD STE 1020
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City | ENCINO
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State | CA
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Zip | 91436-2611
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Country | US
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Telephone | 310-592-0597
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Fax |
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Authorized Official
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Title or Position | OWNER/MARRIAGE & FAMILY THERAPIST
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Name | MRS. MICHELLE MASSI
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Credential | MFT
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Telephone | 310-592-0597
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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 | 48857
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License Number State | CA
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