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Individual

ALICIA DEWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
2900 RIVERSIDE DRIVE, UNIT 1, LOS ANGELES, CA 90039
(323) 207-6479
Mailing address
5433 ABBOTT PL APT 7, LOS ANGELES, CA 90042-3300

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
119858
CA
101YM0800X
Mental Health Counselor
Primary
133369
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119858
AMFT REGISTRATION
CA
01
133369
LMFT LICENSE
CA
Enumeration date
11/03/2020
Last updated
11/02/2022
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