| NPI | 1649591520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE KELL Owner 951-678-1642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC39965) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |