| NPI | 1811390081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLEMIJN JOHANNA CAMPBELL Clinical Director 310-456-4937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA MFC47309) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC47309) |
| 251S00000X (Licence: CA 11212499) | |
| 252Y00000X Early Intervention Provider Agency (Licence: CA 11212499) | |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |