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General NPI Number Information
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NPI Number | 1942608781
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Entity Type | Organization
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Legal Business Name | AMIE LOWERY LUYTIES INC
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 600 E OCEAN BLVD STE 400B
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City | LONG BEACH
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State | CA
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Zip | 90802-5013
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Country | US
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Telephone | 562-310-9741
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Fax | 888-746-6008
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Provider Business Mailing Address
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Address Line | 600 E OCEAN BLVD STE 400B
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City | LONG BEACH
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State | CA
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Zip | 90802-5013
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Country | US
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Telephone | 562-310-9741
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Fax | 888-746-6008
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Authorized Official
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Title or Position | OWNER
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Name | AMIE LOWERY LUYTIES
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Credential | MFT
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Telephone | 562-310-9741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 41428
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License Number State | CA
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