Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | 29302 | CA |
Y | 103TC0700X | Clinical Psychologist | 29302 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1134401011 |
---|---|
Provider Name | Meredith Moersch |
First Address | Sherman Oaks, CA 91401-6037 |
Second Address | Pacific Palisades, CA 90272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2011 |
Last Update Date | 30/12/2020 |