| NPI | 1952080871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER DOMINGO Manager 916-513-0468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-07-17 |