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Organization
GRAY WHALE MARRIAGE AND FAMILY THERAPY PROF CORP
Active
Organization
GRAY WHALE MARRIAGE AND FAMILY THERAPY PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREN VICTORIA BRUASKI LMFT (PRESIDENT)
(619) 213-2470
Entity
Organization
Contact information
Practice address
8426 FIRESIDE AVE, SAN DIEGO, CA 92123-2848
(714) 337-4969
Mailing address
PO BOX 231012, SAN DIEGO, CA 92193-1012
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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