| NPI | 1548883317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTEBAN GONZALEZ Contracts/Credentialing Specialist 619-323-0832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-07-02 |