| NPI | 1649563776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA MAXINE GANTT Provider 805-922-1093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC27809) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2011-05-23 |