Individual
ANNICK JULIA TYTGAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 W VICTORIA ST, GARDENA, CA 90248-3523
(310) 715-2020
Mailing address
130 W VICTORIA ST, GARDENA, CA 90248-3523
(310) 715-2020
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT91098
CA
Other
Enumeration date
04/19/2013
Last updated
12/28/2015
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