NPI | 1992460430 |
---|---|
Doing Business As | WANDER PSYCHOTHERAPY |
Entity Type | Organization |
Authorized Contact | MIRANDA ROSE ROTH MILLICAN CEO 619-736-0495 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2021-10-31 |
Last Update Date | 2021-10-31 |