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General NPI Number Information
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NPI Number | 1316368558
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Entity Type | Organization
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Legal Business Name | KATHRYN TULL INC
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 3760 MOTOR AVE STE 315
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City | LOS ANGELES
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State | CA
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Zip | 90034-6404
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Country | US
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Telephone | 310-920-9480
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Fax | 310-204-5030
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Provider Business Mailing Address
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Address Line | 3760 MOTOR AVE STE 315
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City | LOS ANGELES
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State | CA
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Zip | 90034-6404
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Country | US
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Telephone | 310-920-9480
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Fax | 310-204-5030
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | KATHRYN A. TULL
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Credential | M.A.,LMFT
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Telephone | 310-920-9480
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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 | MFC44809
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License Number State | CA
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