| NPI | 1902488208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVVONNE WALLS CEO 714-457-7157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2021-08-12 |