| NPI | 1619734050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEJANDRA MIRANDA RODRIGUEZ Lpc 458-209-9084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |