| NPI | 1578454237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAH A RIDEAUX Clinical Director 619-732-6160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-07-11 |
| Last Update Date | 2025-07-11 |