NPI | 1457800385 |
---|---|
Entity Type | Organization |
Authorized Contact | KHALIDA KHANUM Program Director 909-825-8080 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LCSW28947) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LCSW28841) |
106H00000X Marriage & Family Therapist (Licence: CA MFTI60442) | |
Enumeration Date | 2016-10-04 |
Last Update Date | 2016-10-04 |