Organization
KW COUPLES THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIAUNDRA JACKSON (CEO)
(310) 751-0389
Entity
Organization
Contact information
Practice address
400 CONTINENTAL BLVD FL 6, EL SEGUNDO, CA 90245-5074
(310) 751-0389
Mailing address
PO BOX 7531, LONG BEACH, CA 90807-0531
(310) 751-0389
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
100193
CA
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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