| NPI | 1780931949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN KUBACKY Owner/President 310-625-6083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY21917) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2022-11-17 |