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General NPI Number Information
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NPI Number | 1477091841
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Entity Type | Individual
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Provider Name | MIA CATHERINE BLAKELY-BROWN LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 09/30/2023
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Provider Practice Location Address
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Address Line | 595 E COLORADO BLVD STE 423
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City | PASADENA
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State | CA
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Zip | 91101-2018
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Country | US
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Telephone | 818-538-9855
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Fax | 877-706-2228
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Provider Business Mailing Address
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Address Line | 595 E COLORADO BLVD STE 423
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City | PASADENA
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State | CA
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Zip | 91101-2018
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Country | US
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Telephone | 818-538-9855
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Fax | 877-706-2228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LMFT96145
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License Number State | CA
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