Betty Omlor, LMFT

Individual provider Active NPI Marriage & Family Therapist · Wrightwood, CA

NPI 1962289017 · NPPES record last updated Jun 10, 2024

Key facts

NPI
1962289017
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LMFT132862 (CA)
Practice address
1420 Betty Street
Wrightwood, CA 92397-0481
Phone
(909) 319-1144
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LMFT132862CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT132862 CA Yes

Addresses

Primary practice location

1420 Betty Street
Wrightwood, CA 92397-0481

Mailing address

P.O. Box 481
Wrightwood, CA 92397-0481
Phone (909) 319-1144

Other providers in Wrightwood, CA

All providers in Wrightwood, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.