Provider Information for 1174659676
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VIRGINIA A MINTZLAFF M.S.,LMFT
Sex: Female
NPI: 1174659676
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174659676 | ||||||||
| Enumeration Date | 2007-02-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 128 E KATELLA AVE SUITE 200 ORANGE, CA 92867-4836 United States Phone: 714-292-2292 | Fax:714-771-9710 | ||||||||
| Primary Practice Address | 128 E KATELLA AVE SUITE 200 ORANGE, CA 92867-4836 United States Phone: 714-292-2292 | Fax:714-771-9710 | ||||||||
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