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General NPI Number Information
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NPI Number | 1821115353
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Entity Type | Individual
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Provider Name | SLOANE FABRICIUS LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30497 CANWOOD ST SUITE 103
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4330
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Country | US
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Telephone | 805-558-3871
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Fax | 818-706-9070
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Provider Business Mailing Address
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Address Line | 4651 CALLE NORTE
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6812
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Country | US
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Telephone | 805-376-8132
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Fax |
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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 | MFC 40517
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License Number State | CA
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