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NPI 1972140432

NPI 1972140432 : OAK AND STONE MARRIAGE AND FAMILY THERAPY, INC. : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1972140432
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    Entity Type          |    Organization 
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    Legal Business Name  |    OAK AND STONE MARRIAGE AND FAMILY THERAPY, INC. 
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Dates
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    Enumeration Date     |    12/04/2019
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    Last Update Date     |    12/04/2019
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Provider Practice Location Address
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    Address Line         |    5619 NORTH FIGUEROA STREET #212
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90042
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    Country              |    US
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    Telephone            |    213-394-6404
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5619 NORTH FIGUEROA STREET #212
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90042
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    Country              |    US
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    Telephone            |    213-394-6404
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     HATTY J LEE 
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    Credential           |    LMFT
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    Telephone            |    213-394-6404
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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       |    
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    License Number State |    
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