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General NPI Number Information
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NPI Number | 1720803174
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Entity Type | Organization
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Legal Business Name | SEVEN DUCKS THERAPY
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 6718 VAN NOORD AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1105
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Country | US
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Telephone | 574-551-0710
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Fax |
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Provider Business Mailing Address
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Address Line | 6718 VAN NOORD AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1105
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Country | US
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Telephone | 574-551-0710
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRITTANY DECKER KUSSEROW
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Credential | LMFT
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Telephone | 574-551-0710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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