| NPI | 1134828403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA PROVENCE Lmft (Therapist) 619-354-2249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-03-09 |