| NPI | 1417611278 |
|---|---|
| Doing Business As | MENTAL HEALTH THERAPIST |
| Entity Type | Organization |
| Authorized Contact | MATT FOX Owner 916-886-7996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2021-10-27 |