Provider Demographics
NPI:1255090890
Name:ELIZABETH ANNE HOLLON MARRIAGE AND FAMILY THERAPIST INC
Entity type:Organization
Organization Name:ELIZABETH ANNE HOLLON MARRIAGE AND FAMILY THERAPIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-293-9133
Mailing Address - Street 1:801 PARK RD
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2943
Mailing Address - Country:US
Mailing Address - Phone:714-293-9133
Mailing Address - Fax:714-841-0140
Practice Address - Street 1:801 PARK RD
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2943
Practice Address - Country:US
Practice Address - Phone:714-293-9133
Practice Address - Fax:714-841-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty