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Stacy Smith Liss

Counselor, Addiction (Substance Use Disorder) in Los Angeles, CA. Individual provider (NPI-1).

NPI number1316601362
StatusActive
Last updated in NPPESOct 26, 2021

Details

NPI
1316601362
Entity type
Individual (NPI-1)
Name
Stacy Smith Liss
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 26, 2021
Certification date
Oct 26, 2021
Last updated
Oct 26, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)––Yes

Practice location

8831 Venice Blvd
Los Angeles, CA 90034-3223

Phone 310-204-5200

Mailing address

8831 Venice Blvd
Los Angeles, CA 90034-3223

Phone 310-204-5200

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