| NPI | 1861210676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH COKE Owner 559-360-7677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |