Organization
TIA BRISCO, LICENSED MARRIAGE AND FAMILY THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIA BRISCO LMFT (OWNER)
(661) 675-8756
Entity
Organization
Contact information
Practice address
17130 DEVONSHIRE ST STE 104A, NORTHRIDGE, CA 91325-1676
(661) 675-8756
Mailing address
17130 DEVONSHIRE ST STE 104A, NORTHRIDGE, CA 91325-1676
(661) 675-8756
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/16/2020
Last updated
04/25/2020
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