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General NPI Number Information
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NPI Number | 1700607710
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Entity Type | Organization
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Legal Business Name | SHEILA THIELE LICENSED MARRIAGE AND FAMILY THERAPIST A PROFESSIONAL CO
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 3371 GLENDALE BLVD STE 218
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City | LOS ANGELES
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State | CA
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Zip | 90039-1857
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Country | US
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Telephone | 310-497-0566
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Fax |
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Provider Business Mailing Address
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Address Line | 1722 WINONA BLVD APT 210
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City | LOS ANGELES
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State | CA
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Zip | 90027-3892
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Country | US
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Telephone | 310-497-0566
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | SHEILA EMILY THIELE
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Credential | LMFT
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Telephone | 310-497-0566
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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 |
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License Number State |
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