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General NPI Number Information
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NPI Number | 1346966736
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Entity Type | Organization
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Legal Business Name | THE TRAVELING THERAPIST, INC.
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 702 W ATHENS BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90044-3921
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Country | US
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Telephone | 213-503-7590
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Fax |
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Provider Business Mailing Address
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Address Line | 702 W ATHENS BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90044-3921
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Country | US
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Telephone | 213-503-7590
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | LUVONNE GENISE RICHARDSON-KING
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Credential | LCSW 22396
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Telephone | 213-503-7590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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