| NPI | 1457095986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED ABRAHAM DOEGEY Owner 909-276-7720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TH0004X Psychologist, Health | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-05-06 |