JASON ICKOVITZ

LOS ANGELES, CA
NPI1083076368
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CA  80112)
Enumeration Date2016-03-24
Last Update Date2016-03-24
Business Address
-- JASON ICKOVITZ LMFT
8170 BEVERLY BLVD 203
LOS ANGELES, CA 90048-4524
Phone number: 424-274-1564
Mailing Address
-- JASON ICKOVITZ LMFT
317 N OGDEN DR
LOS ANGELES, CA 90036-2130
Phone number: 310-650-2501