| NPI | 1861920753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REYA KOST Vice President 858-750-9016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2021-11-30 |