Provider Demographics
NPI:1588422976
Name:TANIA DAVOODI, MFT MARRIAGE & FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:TANIA DAVOODI, MFT MARRIAGE & FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVOODI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-648-8842
Mailing Address - Street 1:11041 HORTENSE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1717
Mailing Address - Country:US
Mailing Address - Phone:818-648-8842
Mailing Address - Fax:
Practice Address - Street 1:11041 HORTENSE ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-1717
Practice Address - Country:US
Practice Address - Phone:818-648-8842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty