| NPI | 1073244174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE NICOLE WIEMHOLT Owner 805-874-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician | |
| 225800000X Recreation Therapist | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2022-06-20 |