| NPI | 1366017535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DR. MONICA ELLIS-BLIED Director 909-741-2849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |