| Teleconnect Therapies | |
|
22 Canyon Terrace Avalon CA 90704 | |
| (310) 850-2960 | |
| Not Available |
| Full Name | Teleconnect Therapies |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 22 Canyon Terrace, Avalon, California |
| Authorized Official Name and Position | Dawn Marie Sampson (PARTNER) |
| Authorized Official Contact | 3108502960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Teleconnect Therapies Po Box 1665 Avalon CA 90704-1665 Ph: (310) 850-2960 | Teleconnect Therapies 22 Canyon Terrace Avalon CA 90704 Ph: (310) 850-2960 |
| NPI Number | 1871738112 |
|---|---|
| Provider Enumeration Date | 12/15/2008 |
| Last Update Date | 04/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871738112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY21275 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCS23139 (California) | Primary |