Organization
CHILD COUNSELING & BEHAVIOR THERAPY CLINIC
Active
Organization
CHILD COUNSELING & BEHAVIOR THERAPY CLINIC
Active
Other names
Behavior Therapy Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE EDWARD TASHJIAN MFT, BCBA (DIRECTOR)
(818) 788-2388
Entity
Organization
Contact information
Practice address
15720 VENTURA BLVD, SUITE 403, ENCINO, CA 91436-2914
(818) 788-2388
(818) 788-3875
Mailing address
15720 VENTURA BLVD, SUITE 403, ENCINO, CA 91436-2914
(818) 788-2388
(818) 788-3875
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BCBA # 1-10-7653
CA
251S00000X
Community/Behavioral Health Agency
Primary
MFC30490
CA
Other
Enumeration date
07/27/2012
Last updated
11/01/2012
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