| NPI | 1588960322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNES CLAIRE DICKSON Owner 714-569-9910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY12015) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-06-14 |