NPI | 1114411618 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA FOSS President 626-840-5740 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY28674) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT83193) |
Enumeration Date | 2018-06-18 |
Last Update Date | 2018-06-18 |