DIANA GRACE MACK

GLENDALE, CA
NPI1174958409
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: CA  LCSW73928)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: CA  LCSW 73928)
225400000X Rehabilitation Practitioner
Enumeration Date2013-09-05
Last Update Date2021-12-03
Business Address
-- DIANA GRACE MACK
1540 E COLORADO ST
GLENDALE, CA 91205-1514
Phone number: 818-244-7257
Mailing Address
-- DIANA GRACE MACK
4760 SEPULVEDA BLVD
CULVER CITY, CA 90230-4820
Phone number: 310-390-6612