| NPI | 1568981991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYCLAIRE MENA Lcsw 551-427-4850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 44SC00193900) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |