Individual
MADELEINE SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11845 W OLYMPIC BLVD STE 1050W, LOS ANGELES, CA 90064-5046
(424) 330-2217
Mailing address
7046 CREBS AVE, RESEDA, CA 91335-4024
(615) 415-0187
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10986
CA
Other
Enumeration date
01/21/2022
Last updated
02/13/2023
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