| NPI | 1356020705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISTO CHAPMAN CEO 818-321-1095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-13 |