Provider Demographics
NPI:1558808725
Name:DR. IHLE AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DR. IHLE AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:IHLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:562-477-4765
Mailing Address - Street 1:4143 LEVELSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-4019
Mailing Address - Country:US
Mailing Address - Phone:562-477-4765
Mailing Address - Fax:562-433-8152
Practice Address - Street 1:4137 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-5311
Practice Address - Country:US
Practice Address - Phone:562-433-7652
Practice Address - Fax:562-433-8152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13704103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty