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Organization
SD INTERVIEW
Active
Organization
SD INTERVIEW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GIANCOLA (LMFT)
(619) 964-8288
Entity
Organization
Contact information
Practice address
8885 RIO SAN DIEGO DR STE 365, SAN DIEGO, CA 92108-1627
(619) 964-8288
(619) 566-4126
Mailing address
8885 RIO SAN DIEGO DR STE 365, SAN DIEGO, CA 92108-1627
(619) 964-8288
(619) 566-4126
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT53346
CA
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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