Provider Demographics
NPI:1699881763
Name:ABRAMS, PHYLLIS M (MFT 8024)
Entity type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:M
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:MFT 8024
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12163 LAUREL TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3645
Mailing Address - Country:US
Mailing Address - Phone:818-985-6979
Mailing Address - Fax:818-985-5892
Practice Address - Street 1:12163 LAUREL TERRACE DR
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3645
Practice Address - Country:US
Practice Address - Phone:818-985-6979
Practice Address - Fax:818-985-5892
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 8024106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist