NPI | 1285301770 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA MOLINA Credentialing Leader 888-878-8595 |
Organization Subpart ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
103TC0700X Psychologist, Clinical | |
1041C0700X Social Worker, Clinical | |
2084P0800X Psychiatry & Neurology, Psychiatry | |
Enumeration Date | 2021-08-24 |
Last Update Date | 2025-07-21 |