Individual
MS. AILLETH VAICY TOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
333 S BEAUDRY AVE, 29TH FLOOR, LOS ANGELES, CA 90017-1466
(213) 241-2174
(213) 241-3305
Mailing address
333 S BEAUDRY AVE, 29TH FLOOR, LOS ANGELES, CA 90017-1466
(213) 241-2174
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS 28725
CA
Other
Enumeration date
04/24/2012
Last updated
06/20/2013
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