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General NPI Number Information
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NPI Number | 1689687394
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Entity Type | Organization
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Legal Business Name | FAMILY THERAPIST ART RESOURCES, INC.
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 107 S FAIR OAKS AVE SUITE #310
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City | PASADENA
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State | CA
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Zip | 91105-2010
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Country | US
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Telephone | 949-689-6527
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Fax |
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Provider Business Mailing Address
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Address Line | 107 S FAIR OAKS AVE SUITE #310
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City | PASADENA
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State | CA
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Zip | 91105-2010
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Country | US
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Telephone | 949-689-6527
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Fax |
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Authorized Official
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Title or Position | CEO / DIRECTOR
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Name | MRS. MELINDA JO EMERY
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Credential | A.T.R.-B.C, M.F.T.,
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Telephone | 949-689-6527
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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 | 35004
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License Number State | CA
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