Organization
ILLUMINATION GERIATRIC CONSULTATION AND COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MARY MILLER LCSW (LICENSED CLINICAL SOCIAL WORKER/CEO)
(818) 568-6244
Entity
Organization
Contact information
Practice address
1832 SCOTT RD, BURBANK, CA 91504-3819
(818) 568-6244
Mailing address
1832 SCOTT RD, BURBANK, CA 91504-3819
(818) 568-6244
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
26431
CA
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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