| NPI | 1093074684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN GENTZ GILLESPIE Proprietor 415-609-8205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DC LMFT000140) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CA MFT 38572) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |