| NPI | 1013377647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA KYLE GLASS Director 916-716-1795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 53491) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 53491) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2016-02-24 |