| NPI | 1720708852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI ROXANNE DAVIS Owner 310-999-9055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |