| NPI | 1013733351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HADI KOESNODIHARDJO Member 415-968-9540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2024-12-03 |