| NPI | 1629408190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE MARIE COOK Secretary Office Manager 909-996-7892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY12904) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC39894) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |