Organization
AUTISM ASPERGER SUPPORT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIAN N TACKETT MA (OWNER/CLINICAL DIRECTOR)
(310) 567-0504
Entity
Organization
Contact information
Practice address
6656 W 81ST ST, LOS ANGELES, CA 90045-2827
(310) 567-0504
Mailing address
6656 W 81ST ST, LOS ANGELES, CA 90045-2827
(310) 567-0504
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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