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General NPI Number Information
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NPI Number | 1649862954
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Entity Type | Organization
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Legal Business Name | EG THERAPY CENTERS
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 7576 SAN FERNANDO RD
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City | SUN VALLEY
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State | CA
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Zip | 91352-4346
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Country | US
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Telephone | 818-824-1159
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Fax |
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Provider Business Mailing Address
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Address Line | 6854 COSTELLO AVE
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City | VAN NUYS
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State | CA
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Zip | 91405-4105
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Country | US
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Telephone | 818-824-1159
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MRS. ELIZABETH GASPARYAN
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Credential | LCSW
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Telephone | 818-824-1159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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