| NPI | 1124849658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNES WONG NICKERSON Associate VP Of Financial Operation 619-594-6017 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 104100000X Social Worker |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |