| NPI | 1104330547 |
|---|---|
| Other Name | MIVEN TRAGESER, MFT |
| Entity Type | Organization |
| Authorized Contact | MIVEN BOOTH TRAGESER Principal 323-813-8238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 1339) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 1339) |
| 106H00000X Marriage & Family Therapist (Licence: CA 49725) | |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |