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General NPI Number Information
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NPI Number | 1912668187
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Entity Type | Organization
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Legal Business Name | RECONNECT MARRIAGE AND FAMILY COUNSELING
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 8949 LANGDON AVE. APT 39
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City | NORTH HILLS
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State | CA
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Zip | 91343
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Country | US
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Telephone | 626-283-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 1812 W BURBANK BLVD UNIT 853
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City | BURBANK
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State | CA
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Zip | 91506-1315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | CYMONE NOEL DAMON-DAVID
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Credential | LMFT
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Telephone | 626-283-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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