| NPI | 1114439890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY A HANNIFIN Psychologist/President 310-710-3027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY24515) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |