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General NPI Number Information
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NPI Number | 1598240723
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Entity Type | Organization
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Legal Business Name | JLM MARRIAGE AND FAMILY THERAPY INC.
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 1991 VILLAGE PARK WAY STE 100
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City | ENCINITAS
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State | CA
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Zip | 92024-1966
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Country | US
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Telephone | 858-633-6760
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Fax |
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Provider Business Mailing Address
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Address Line | 1991 VILLAGE PARK WAY STE 100
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City | ENCINITAS
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State | CA
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Zip | 92024-1966
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Country | US
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Telephone | 858-633-6760
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MRS. JENNIER MANDERSCHEID
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Credential | MFT
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Telephone | 858-337-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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