| NPI | 1124212295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELENE LAWS Sr. Contract Administrator 323-344-5536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2022-11-11 |