| NPI | 1346077450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SHADER President 657-234-2206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2024-09-14 |
| Last Update Date | 2024-09-14 |