Organization
CODI BENOLOGA LICENSED CLINICAL SOCIAL WORKER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODI JO BENOLOGA LCSW (OWNER/DIRECTOR)
(480) 221-4972
Entity
Organization
Contact information
Practice address
4195 N VIKING WAY STE 333, LONG BEACH, CA 90808-1466
(562) 568-9005
Mailing address
4195 N VIKING WAY STE 333, LONG BEACH, CA 90808-1466
(562) 568-9005
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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