Individual provider · Type 1 NPI

Mary Tieche

Addiction (Substance Use Disorder) Counselor · Venice, CA

NPI number 1497472617 Active

Practice location

503 Ocean Front Walk
Venice, CA 90291-2403

Call (310) 392-3070 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X16068 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1497472617

Mary Tieche's National Provider Identifier is 1497472617, issued on Oct 27, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Venice, CA. The record was last updated on Oct 27, 2022.