Provider Demographics
NPI:1073277299
Name:PERSONAL CONNECTIONS THERAPY, INC.
Entity Type:Organization
Organization Name:PERSONAL CONNECTIONS THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALBADAWI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-730-6208
Mailing Address - Street 1:440 W BASELINE RD STE B
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1607
Mailing Address - Country:US
Mailing Address - Phone:714-584-0484
Mailing Address - Fax:
Practice Address - Street 1:440 W BASELINE RD STE B
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1607
Practice Address - Country:US
Practice Address - Phone:714-584-0484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty