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General NPI Number Information
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NPI Number | 1578279733
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Entity Type | Organization
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Legal Business Name | WHOLE SPACE FAMILY THERAPY, INC
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 16885 W BERNARDO DR STE 245
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City | SAN DIEGO
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State | CA
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Zip | 92127-1619
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Country | US
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Telephone | 858-946-6887
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Fax |
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Provider Business Mailing Address
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Address Line | 16885 W BERNARDO DR STE 245
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City | SAN DIEGO
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State | CA
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Zip | 92127-1619
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Country | US
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Telephone | 858-946-6887
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Fax |
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | ALYSON LISCHER
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Credential | LMFT, CEDS-S
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Telephone | 858-946-6823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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