| NPI | 1881486850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SU BOUDREAU President 858-225-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-21 |