| NPI | 1336889963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY NICKELL President 858-314-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-09-28 |