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General NPI Number Information
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NPI Number | 1629447024
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Entity Type | Individual
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Provider Name | DAISY SPOOLER MSW
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Gender | Female
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 5980 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-2657
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Country | US
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Telephone | 310-893-3269
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6253
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91603-6253
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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 |
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Name |
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Credential |
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Telephone |
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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 | 66910
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License Number State | CA
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