| NPI | 1205082831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE E HANES Sue E. Shrader, Mft 858-337-5291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC30118) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-20 |