| NPI | 1770040792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DUTILE Owner 562-682-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |