| NPI | 1275169708 |
|---|---|
| Former Legal Business Name | CENTRAL COAST DBT |
| Entity Type | Organization |
| Authorized Contact | ANGELA VIGNA CEO/President 318-548-3270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-03-16 |