| NPI | 1366218919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEDDIE JACKSON Owner 858-867-9474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2024-08-26 |