Individual
MISS CORY AMBER LUSTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
526 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(707) 815-7729
Mailing address
526 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(707) 815-7729
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/19/2012
Last updated
01/05/2015
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