| NPI | 1831681428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID JENNIFER LACEY Licensed Professional Counselor 415-913-8831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA 008680) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |