Individual
MS. ANDREA ELLEN MIKONOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LMFT
Contact information
Practice address
4237 INGLEWOOD BLVD, APT 103, LOS ANGELES, CA 90066-5870
(310) 902-6854
Mailing address
4237 INGLEWOOD BLVD, APT 103, LOS ANGELES, CA 90066-5870
(310) 902-6854
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC 52248
CA
Other
Enumeration date
09/07/2011
Last updated
08/24/2014
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