| NPI | 1164814174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAUN BAKER A VP Training And Licensure Affairs 310-481-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2015-02-27 |