NPI | 1174762058 |
---|---|
Other Name | MARK FAIRFIELD, LCSW, BCD |
Entity Type | Organization |
Authorized Contact | MARK FAIRFIELD President/CEO 310-339-0609 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: CA LCS19969) |
Enumeration Date | 2009-02-17 |
Last Update Date | 2009-02-17 |