Most Relevant Information
Provider Data
| NPI Number: | 1003361692 |
| Provider Name: | HARRISON BODRIE LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 109141 |
Most Important Dates
| Enumeration Date: | 08/24/2016 |
| Last Updated: | 03/07/2024 |
Provider Practice Location
11301 WILSHIRE BLVD
LOS ANGELES
CA
900731003
Practice Location Phone/Fax
| Phone: | 3109878310 |
| Fax: |
Provider Mailing Location
11301 WILSHIRE BLVD
LOS ANGELES
CA
900731003
Provider Mailing Phone/Fax
| Phone: | 3109878310 |
| Fax: |