| NPI | 1487308672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA BRAVO-MONTES Owner 619-207-3978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-02-08 |