| NPI | 1215715537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESA SHAWN VANDER BIE Marriage & Family Therapist 949-653-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |