| NPI | 1750773396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LARSON Manager 916-712-0226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 37375) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-02-18 |