| NPI | 1417513458 |
|---|---|
| Doing Business As | PORTA VERUM PSYCHOTHERAPY SERVICES |
| Entity Type | Organization |
| Authorized Contact | PAULA KETTULA President 619-577-5057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2019-05-15 |