| NPI | 1477971810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME WATSON Director 909-915-4998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 48090) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |