Provider Demographics
NPI:1245064765
Name:GHIO MARRIAGE AND FAMILY THERAPY SERVICES
Entity type:Organization
Organization Name:GHIO MARRIAGE AND FAMILY THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GHIO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-707-5520
Mailing Address - Street 1:1536 W 25TH ST # 257
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-4415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:624 W 9TH ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3158
Practice Address - Country:US
Practice Address - Phone:310-707-5520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty