| NPI | 1417429242 |
|---|---|
| Doing Business As | IDA VANDAEI LCSW |
| Entity Type | Organization |
| Authorized Contact | IDA VANDAEI Provider 818-646-6683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2023-11-11 |