| NPI | 1225563810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIA LORENA BOUCHER Psychotherapist 310-435-7883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CA 99323) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-04-21 |