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 |