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General NPI Number Information
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NPI Number | 1528696507
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Entity Type | Organization
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Legal Business Name | THE RESTORATIVE THERAPY PROJECT
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 506 S SPRING ST UNIT 13308
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City | LOS ANGELES
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State | CA
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Zip | 90013-3215
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Country | US
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Telephone | 310-564-6749
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Fax |
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Provider Business Mailing Address
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Address Line | 506 S SPRING ST UNIT 13308
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City | LOS ANGELES
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State | CA
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Zip | 90013-3215
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Country | US
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Telephone | 310-564-6749
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MS. SHELLY ANNE GUTENSOHN
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Credential | LMFT
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Telephone | 310-564-6749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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