| NPI | 1992949754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL H. SIECK Director 909-798-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PY7061) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-04-23 |