| NPI | 1528595493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTINY CHAMPION Co Owner 805-407-8235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 39699) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2018-03-17 |