NPI | 1356725808 |
---|---|
Other Name | AVERY'S HEROES |
Entity Type | Organization |
Authorized Contact | LYNDEE VENOSTA Manager 760-805-4127 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: PSY24897) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT96181) |
Enumeration Date | 2015-07-15 |
Last Update Date | 2017-01-06 |