| NPI | 1649685439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MILLER Member 760-310-8233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MT 104100000X) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MT 101Y00000X) |
| 101YM0800X Counselor Mental Health (Licence: MT 101YM0800X) | |
| 106H00000X Marriage & Family Therapist (Licence: MT 106H00000X) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |