| NPI | 1912525791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGINA INES LAMPHERE SULLIVAN Clinical Psychologist 909-987-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |