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General NPI Number Information
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NPI Number | 1982000485
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Entity Type | Organization
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Legal Business Name | GLENN L ABRAMS MARRIAGE FAMILY & CHILD COUNSELING INC.
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 133 E BONITA AVE STE. 205
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City | SAN DIMAS
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State | CA
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Zip | 91773-3173
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Country | US
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Telephone | 909-718-9354
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Fax |
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Provider Business Mailing Address
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Address Line | 133 E BONITA AVE STE. 205
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City | SAN DIMAS
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State | CA
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Zip | 91773-3173
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Country | US
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Telephone | 909-718-9354
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GLENN LEE ABRAMS
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Credential | LMFT
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Telephone | 909-718-9354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 57325
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License Number State | CA
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