Individual
ALYSSA IACONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4025 W 226TH ST, TORRANCE, CA 90505-2340
(310) 373-4556
Mailing address
4025 W 226TH ST, TORRANCE, CA 90505-2340
(310) 373-4556
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
96149
CA
1041C0700X
Clinical Social Worker
Primary
96149
CA
Other
Enumeration date
01/22/2014
Last updated
05/13/2021
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