| NPI | 1063741940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY TENNANT Owner 760-740-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106H00000X Marriage & Family Therapist | |
| 2251P0200X Physical Therapist Pediatrics | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2009-12-23 |