| NPI | 1578451571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE SMITH Insurance Specialist 951-249-3644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-06-26 |