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General NPI Number Information
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NPI Number | 1578964243
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Entity Type | Organization
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Legal Business Name | EMMA BOGDANOFF, MFT
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Dates
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Enumeration Date | 09/11/2014
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | 566 S SAN VICENTE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90048-4650
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Country | US
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Telephone | 386-451-1256
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Fax |
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Provider Business Mailing Address
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Address Line | 1354 N HARPER AVE APT 209
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-3777
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EMMA BOGDANOFF, MFT
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Name | EMMA BOGDANOFF
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Credential | MFTI
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Telephone | 386-451-1256
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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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