Individual
BLAINE MCFADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1527 4TH ST, SANTA MONICA, CA 90401-2358
(310) 394-9871
Mailing address
1527 4TH ST, SANTA MONICA, CA 90401-2358
(310) 394-9871
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS28666
CA
Other
Enumeration date
04/06/2014
Last updated
09/30/2014
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