Provider Information for 1134252661
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Ms. SHUTONDIA KAY TAPP LMFT
Sex: Female
NPI: 1134252661
Last Updated: 2024-09-08
Certification Date: 2024-09-08
Certification Date: 2024-09-08
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1134252661 | ||||||||
| Enumeration Date | 2007-03-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4211 AVALON BLVD LOS ANGELES, CA 90011-5622 United States Phone: 323-295-4299 | Fax: | ||||||||
| Primary Practice Address | 4211 AVALON BLVD LOS ANGELES, CA 90011-5622 United States Phone: 323-295-4299 | Fax: | ||||||||
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