Organization
ANGEL BRIDGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY JAYNE CARLSON-COLLINS PH.D. (OWNER)
(805) 371-1679
Entity
Organization
Contact information
Practice address
1414 E THOUSAND OAKS BLVD, #103, THOUSAND OAKS, CA 91362-4401
(805) 371-1679
Mailing address
1414 E THOUSAND OAKS BLVD, #103, THOUSAND OAKS, CA 91362-4401
(805) 371-1679
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MA14528
CA
Other
Enumeration date
11/14/2006
Last updated
08/22/2020
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