| NPI | 1518565076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTEBAN GONZALEZ Contracts And Credentialing Spec 619-323-0832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 208000000X Pediatrics |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |