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General NPI Number Information
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NPI Number | 1518451871
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Entity Type | Organization
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Legal Business Name | INNA ZAVADSKY MARRIAGE AND FAMILY THERAPY INC.
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 5478 WILSHIRE BLVD STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90036-4230
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Country | US
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Telephone | 310-729-7033
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Fax |
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Provider Business Mailing Address
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Address Line | 5478 WILSHIRE BLVD STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90036-4230
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Country | US
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Telephone | 310-729-7033
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | INNA ZAVADSKY
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Credential | MA, LMFT
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Telephone | 310-729-7033
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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 | 51957
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License Number State | CA
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