Organization
GRACE E. HAZELTINE BARTMAN, PH.D., PSYCHOLOGIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE E HAZELTINE PHD (OWNER)
(323) 553-2205
Entity
Organization
Contact information
Practice address
4212 1/2 OVERLAND AVE, CULVER CITY, CA 90230-3736
(323) 553-2205
Mailing address
4212 1/2 OVERLAND AVE, CULVER CITY, CA 90230-3736
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578008256
NPI
—
Enumeration date
01/18/2023
Last updated
01/18/2023
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