| NPI | 1184009508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH V MACIAS Owner 408-420-5730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 8173984-6009) |
| Additional Taxonomies | 251S00000X (Licence: UT 8173984-6009) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |