| NPI | 1003210899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOIRA M CONLEY-JACKSON Owner 909-559-8148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA mfc38902) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |