| NPI | 1699471201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLA MARQUIS President 619-432-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-08-28 |