| NPI | 1568819951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL DONNERSTAG Marriage And Family Therapist 323-620-0636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2022-03-03 |