| NPI | 1881392934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY REZNICEK Owner 530-746-8319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-02-17 |
| Last Update Date | 2023-02-17 |