Individual
ANTANISSHA TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 AVIATION BLVD, REDONDO BEACH, CA 90278-4064
(310) 376-2468
Mailing address
PO BOX 59612, LOS ANGELES, CA 90059-0612
(323) 350-4291
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
117223
CA
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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