MEDICARE: MS. ANITA HARUTUNIAN LMFT

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	MFC46980	CA

General Provider Information

NPI Number	:	1972929123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANITA HARUTUNIAN LMFT

Provider Business Mailing Address
First Line	:	PO BOX 1704
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91209-1704
Country	:	US
Telephone Number	:	818-523-6365
Fax Number	:

Provider Business Practice Location Address
First Line	:	335 MISSION RD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-3327
Country	:	US
Telephone Number	:	818-523-6365
Fax Number	:

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

Provider Enumeration Date	:	03/12/2014
Last Update Date	:	08/27/2015

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