| NPI | 1316471196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF EBBAGE Sole Proprietor 831-239-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 91247) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |