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Organization
TELECONNECT THERAPIES
Active
Organization
TELECONNECT THERAPIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN MARIE SAMPSON LCSW (PARTNER)
(310) 850-2960
Entity
Organization
Contact information
Practice address
22 CANYON TERRACE, AVALON, CA 90704
(310) 850-2960
Mailing address
PO BOX 1665, AVALON, CA 90704-1665
(310) 850-2960
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY21275
CA
1041C0700X
Clinical Social Worker
Primary
LCS23139
CA
Other
Enumeration date
12/15/2008
Last updated
04/26/2013
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