Organization
BUILDING LASTING SUCCESS TOGETHER A PROFESSIONAL PSYCHOTHERAPY CORPORA
Active
Other names
Blast Programs
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE ENNEY PSYD (OWNER)
(818) 583-7134
Entity
Organization
Contact information
Practice address
2512 FOOTHILL BLVD, LA CRESCENTA, CA 91214-3506
(818) 583-7134
Mailing address
2512 FOOTHILL BLVD, LA CRESCENTA, CA 91214-3506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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