Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XM0800X | Mental Health |
NPI | 1225610520 |
---|---|
Provider Name | Sophie Lipman |
First Address | Los Angeles, CA 90048-3625 |
Second Address | Los Angeles, CA 90024-2704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2021 |
Last Update Date | 09/06/2021 |