| NPI | 1932505088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA MEAD Psychologist 909-242-5409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 24298) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |