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General NPI Number Information
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NPI Number | 1295548659
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Entity Type | Organization
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Legal Business Name | AVALON PATH MARRIAGE, COUPLE, AND INDIVIDUAL THERAPY, INC.
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 127 THAMES ST.
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City | THOUSAND OAKS
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State | CA
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Zip | 91360
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Country | US
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Telephone | 818-975-0130
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Fax |
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Provider Business Mailing Address
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Address Line | 5737 KANAN RD # 819
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1601
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Country | US
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Telephone | 818-975-0130
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | LORA HNAT
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Credential | LMFT
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Telephone | 818-975-0130
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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 |
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License Number State |
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