| NPI | 1578016648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE THAYER Senior Clinical Psychologist 619-692-8750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |