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General NPI Number Information
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NPI Number | 1497545529
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Entity Type | Organization
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Legal Business Name | FAMILY INSIGHT & INDIVIDUAL THERAPY INC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 13126 1/4 VALLEYHEART DR
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City | STUDIO CITY
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State | CA
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Zip | 91604-1980
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Country | US
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Telephone | 310-430-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 12605 VENTURA BLVD # 1078
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City | STUDIO CITY
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State | CA
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Zip | 91604-2415
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Country | US
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Telephone | 310-430-5088
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUKAS DZIEMIDOK
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Credential |
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Telephone | 747-356-8388
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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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