| NPI | 1023270725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET MARY TICICH Owner Partner 951-587-6405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA SP 4960) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA OT 2862) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |