Individual
MR. MICHAEL UDO D'AGOSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 654-3845
(818) 345-6402
Mailing address
13244 CUMPSTON ST, SHERMAN OAKS, CA 91401-6008
(818) 997-8039
(818) 376-1077
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
A3555189
CA
103TC1900X
Counseling Psychologist
Primary
PSY24187
CA
Other
Enumeration date
03/13/2007
Last updated
07/29/2011
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