MEDICARE: MRS. BARBARA ROCHELLE WALDMAN LMFT 42244

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	MFT42244

General Provider Information

NPI Number	:	1568617066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA ROCHELLE WALDMAN LMFT 42244

Provider Business Mailing Address
First Line	:	1134 W. OLYMPIC BLVD.
Second Line	:	SUITE 358
City	:	WEST LOS ANGELES
State	:	CA
Zip	:	90064
Country	:	US
Telephone Number	:	310-251-5327
Fax Number	:	310-455-3783

Provider Business Practice Location Address
First Line	:	1134 W. OLYMPIC BLVD.
Second Line	:	SUITE 358
City	:	WEST LOS ANGELES
State	:	CA
Zip	:	90064
Country	:	US
Telephone Number	:	310-251-5327
Fax Number	:	310-455-3783

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

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	11/25/2008

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