Provider Demographics
NPI:1114254612
Name:MCLAUGHLIN-RYAN, JUDY (MA MFT)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:
Last Name:MCLAUGHLIN-RYAN
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 WESTWOOD BLVD
Mailing Address - Street 2:227
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2911
Mailing Address - Country:US
Mailing Address - Phone:310-209-0740
Mailing Address - Fax:310-392-7833
Practice Address - Street 1:1081 WESTWOOD BLVD
Practice Address - Street 2:227
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2911
Practice Address - Country:US
Practice Address - Phone:310-209-0740
Practice Address - Fax:310-392-7833
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist