Individual
MRS. AMALIA MASTRODOMENICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AODC
Contact information
Practice address
6580 VAN NUYS BLVD, VAN NUYS, CA 91401-1426
(818) 908-1740
(818) 908-3336
Mailing address
6254 TAMPA AVE, TARZANA, CA 91335-6643
(818) 593-9589
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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