| NPI | 1972704682 |
|---|---|
| Other Name | FEE FOR SERVICE - MFCC |
| Entity Type | Organization |
| Authorized Contact | RUBEN IMPERIAL Behavioral Health Interim Director 209-525-6225 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2019-10-15 |