| NPI | 1639644818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE KRUSZEWSKI Director 619-836-0046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2018-10-04 |