Individual
MRS. MA LOURDES TAN SOLIVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
5425 PEACHTREE PKWY, PEACHTREE CORNERS, GA 30092-6536
(855) 850-0274
Mailing address
12325 IMPERIAL HWY # 130, NORWALK, CA 90650-8304
(714) 249-8881
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
AMFT134051
CA
Other
Enumeration date
09/09/2022
Last updated
08/14/2024
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