| NPI | 1881254860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PARK Licensed Marriage&Family Therapist 949-891-5336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2019-06-20 |