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General NPI Number Information
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NPI Number | 1437654449
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Entity Type | Organization
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Legal Business Name | LIVE INSPIRED CHILD & FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 2700 NAVAJO RD STE A
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City | EL CAJON
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State | CA
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Zip | 92020-2147
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Country | US
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Telephone | 619-784-3884
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Fax | 619-566-3484
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Provider Business Mailing Address
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Address Line | 5811 AMAYA DR STE 204
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City | LA MESA
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State | CA
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Zip | 91942-4156
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Country | US
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Telephone | 619-933-4105
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ISABELLE DOMINIQUE GEORGE
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Credential | LMFT
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Telephone | 619-784-3883
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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 | 105070
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License Number State | CA
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