| NPI | 1780411462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN BALES Psychologist 619-630-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2024-09-17 |