Individual
ELLEN MEDWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 S SEPULVEDA BLVD, #302, LOS ANGELES, CA 90049-3521
(310) 476-6050
Mailing address
520 S SEPULVEDA BLVD, #302, LOS ANGELES, CA 90049-3521
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
MFC17344
CA
106H00000X
Marriage & Family Therapist
MFC17344
CA
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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