| NPI | 1356916571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIERRA T. ELLIS Psychologist 323-432-0389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |