Individual
DR. GONI HARY BISSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
11340 W OLYMPIC BLVD, SUITE 185, LOS ANGELES, CA 90064-1608
(424) 625-8077
Mailing address
3756 MOORE ST, LOS ANGELES, CA 90066-3533
(310) 710-4817
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY25713
CA
Other
Enumeration date
06/08/2013
Last updated
06/08/2013
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