| NPI | 1467103846 |
|---|---|
| Doing Business As | THAT GAY THERAPIST |
| Entity Type | Organization |
| Authorized Contact | KARISA NICOLE QUICK Owner/CEO 909-808-9607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-02-08 |