NPI | 1770791113 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID GEORGE CONGO President 949-452-9294 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2007-05-18 |
Last Update Date | 2020-08-22 |