| NPI | 1609400837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY EDWARD WILSON Managing Director 562-301-9176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |