| NPI | 1952070252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA LASKA-RUEBUSCH President 707-216-1612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-09-09 |