NPI | 1366084360 |
---|---|
Former Legal Business Name | THERAVILLE COUNSELING SERVICES, A LICENSED CLINICAL SOCIAL WORKER CORP |
Entity Type | Organization |
Authorized Contact | CRYSTAL BURNS Owner/Clinician 909-767-3450 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2019-10-10 |
Last Update Date | 2021-11-04 |