Provider Information for 1346366101
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VANESSA WOMACK LMFT
Sex: Female
NPI: 1346366101
Last Updated: 2018-05-23
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1346366101 | ||||||||
| Enumeration Date | 2007-03-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2907 NICHOLS CANYON RD LOS ANGELES, CA 90046-1240 United States Phone: 818-904-0707 | Fax: | ||||||||
| Primary Practice Address | 3815 W OLIVE AVE STE 102 BURBANK, CA 91505 United States Phone: 818-823-6396 | Fax: | ||||||||
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