| NPI | 1366114464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY WALTERS Owner/Provider 707-654-4659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |