| NPI | 1043691025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YASER SELIM Administrator 909-517-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |