| NPI | 1679268668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRISELDA ENGELAUF Owner/Provider 909-649-3863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-07-20 |