NPI | 1457963076 |
---|---|
Entity Type | Organization |
Authorized Contact | KHALIDA KHANUM Program Director 909-825-8080 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2020-08-17 |
Last Update Date | 2020-08-17 |