Individual
ANI DATASTANYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 E COLORADO ST, GLENDALE, CA 91205-1514
(818) 244-7257
(818) 243-5431
Mailing address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 390-6612
(310) 398-5690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
93455
CA
106H00000X
Marriage & Family Therapist
Primary
93455
CA
Other
Enumeration date
09/01/2015
Last updated
03/13/2017
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