| NPI | 1144748682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAFNA GAUTHIER Program Manager 916-753-4479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 1298) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |