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Individual

APRIL LYNN FISSEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MFT

Contact information

Practice address
1339 20TH ST, SANTA MONICA, CA 90404-2033
(310) 829-8691
Mailing address
2410 1/2 OAK ST, SANTA MONICA, CA 90405-5106
(310) 463-6158

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC52165
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95-1647832
TAX ID
CA
Enumeration date
06/29/2009
Last updated
05/08/2013
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