MEDICARE: MS. PATRICIA ANGELA O'LAUGHLIN MFT, ATR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC 45782	CA

General Provider Information

NPI Number	:	1427186147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANGELA O'LAUGHLIN MFT, ATR

Provider Business Mailing Address
First Line	:	1741 SILVER LAKE BLVD STE 2B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-1256
Country	:	US
Telephone Number	:	323-761-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	1741 SILVER LAKE BLVD STE 2B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-1256
Country	:	US
Telephone Number	:	323-761-2221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	04/30/2012

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