| NPI | 1669717922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN POTTS Owner/ Psychologist 909-904-4462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 23630) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY 23630) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2015-03-26 |