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General NPI Number Information
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NPI Number | 1841643392
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Entity Type | Individual
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Provider Name | ALINE MANOUGUIAN
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Gender | Female
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 11650 RIVERSIDE DR 10
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91602-1093
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Country | US
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Telephone | 818-224-0583
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Fax |
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Provider Business Mailing Address
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Address Line | 2275 HUNTINGTON DR 424
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City | SAN MARINO
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State | CA
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Zip | 91108-2640
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Country | US
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Telephone | 818-414-3290
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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 | 41909
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License Number State | CA
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