| NPI | 1376391540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY WEAR SHUM Owner 909-239-9124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-05-10 |