| NPI | 1215713441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASNEEM BHOLAT Authorized Official 909-815-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2024-04-24 |