Individual
AMANDA DEE MOUSALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
530 SOQUEL AVE, SANTA CRUZ, CA 95062-2301
(831) 426-7322
Mailing address
1630 MERRILL ST APT 106, SANTA CRUZ, CA 95062-4008
(650) 454-0041
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
64001
CA
106H00000X
Marriage & Family Therapist
64001
CA
Other
Enumeration date
02/15/2011
Last updated
03/05/2020
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