Organization
WONDERFUL COUNSELOR HOLISTIC PSYCHIATRIC CARE A PROFESSIONAL NU
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS AHILA MUTHAIYA (OWNER)
(314) 974-7347
Entity
Organization
Contact information
Practice address
4368 EAGLE ROCK BLVD, LOS ANGELES, CA 90041-3211
(314) 974-7347
(314) 843-0201
Mailing address
4368 EAGLE ROCK BLVD, LOS ANGELES, CA 90041-3211
(314) 974-7347
(314) 843-0201
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/03/2024
Last updated
12/19/2024
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