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General NPI Number Information
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NPI Number | 1700270865
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Entity Type | Individual
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Provider Name | MURIEL GHISLAINE GAUDIN MFT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 6345 BALBOA BOULEVARD SUITE 130
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City | ENCINO
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State | CA
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Zip | 91316
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Country | US
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Telephone | 818-403-5592
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Fax | 866-583-0035
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Provider Business Mailing Address
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Address Line | 3356 CANTON LANE
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City | STUDIO CITY
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State | CA
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Zip | 91604-4162
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Country | US
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Telephone | 818-403-5592
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Fax | 866-583-0035
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC35055
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License Number State | CA
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