Provider Demographics
NPI:1447804638
Name:J. DYER MARRIAGE AND FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:J. DYER MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-567-5231
Mailing Address - Street 1:335 E ALBERTONI ST STE 200-817
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1425
Mailing Address - Country:US
Mailing Address - Phone:310-567-5231
Mailing Address - Fax:
Practice Address - Street 1:879 W 190TH ST STE 400
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4223
Practice Address - Country:US
Practice Address - Phone:310-567-5231
Practice Address - Fax:310-635-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty