| NPI | 1164180592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILYON ANTRE MILLER Managing Member 760-470-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 103TS0200X Psychologist School | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2021-12-02 |