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Organization
EMMAUS ROAD CHRISTIAN COUNSELING
Active
Organization
EMMAUS ROAD CHRISTIAN COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA HANSEN (PROGRAM DIRECTOR)
(909) 979-3722
Entity
Organization
Contact information
Practice address
1111 W COVINA BLVD STE 120A, SAN DIMAS, CA 91773-3205
19099793722
Mailing address
1111 W COVINA BLVD STE 120A, SAN DIMAS, CA 91773-3205
19099793722
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
CA
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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