| NPI | 1265211908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON NICOLE WALKER Owner 909-438-8392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2023-10-27 |