| NPI | 1881233047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY LEWIS Clinical Director 323-495-6521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2020-01-04 |
| Last Update Date | 2021-01-28 |