NPI | 1558666982 |
---|---|
Entity Type | Organization |
Authorized Contact | BEVERLY M BREAKEY Clinical Coordinator 209-334-2053 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC30755) |
Enumeration Date | 2011-01-15 |
Last Update Date | 2011-01-15 |