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1154994879
ANTANISSHA TYLER
REDONDO BEACH, CA
NPI
1154994879
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 117223)
Enumeration Date
2021-07-20
Last Update Date
2021-07-20
Business Address
ANTANISSHA TYLER
1200 AVIATION BLVD
REDONDO BEACH, CA 90278-4064
Phone number: 310-376-2468
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Mailing Address
ANTANISSHA TYLER
PO BOX 59612
LOS ANGELES, CA 90059-0612
Phone number: 323-350-4291
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