| NPI | 1245458546 |
|---|---|
| Doing Business As | ETTIE LEE - COVINA |
| Entity Type | Organization |
| Authorized Contact | TERRI VARNUM President & CEO 626-960-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: CA 197802737) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2013-07-29 |