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Organization
FUTURE MOONS
Active
Organization
FUTURE MOONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN SPENCER MA (LMFT)
(310) 600-2037
Entity
Organization
Contact information
Practice address
1511 PARMER AVE, LOS ANGELES, CA 90026-2621
(310) 600-2037
Mailing address
1614 AVALON ST, LOS ANGELES, CA 90026-1816
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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