| NPI | 1295323376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYRENE VICTORIANO Owner 725-400-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2023-04-26 |