Provider Demographics
NPI:1831805928
Name:MIHLON PSYCHOTHERAPY CORP
Entity type:Organization
Organization Name:MIHLON PSYCHOTHERAPY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MIHLON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-329-8761
Mailing Address - Street 1:9400 GROSSMONT SUMMIT DR STE 303
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-4129
Mailing Address - Country:US
Mailing Address - Phone:949-329-8761
Mailing Address - Fax:619-828-7647
Practice Address - Street 1:9400 GROSSMONT SUMMIT DR STE 303
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-4129
Practice Address - Country:US
Practice Address - Phone:949-329-8761
Practice Address - Fax:619-828-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)