| NPI | 1114750759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH K STANTON Clinical Psychologist 619-507-7329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |