| NPI | 1073068144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA JOY MAYNARD Director 888-634-6999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LMFT 46876) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |