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Organization
WAVE PROFESSIONAL CLINICAL COUNSELORS INC.
Active
Organization
WAVE PROFESSIONAL CLINICAL COUNSELORS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BREWER (OWNER)
(760) 500-3325
Entity
Organization
Contact information
Practice address
1207 CARLSBAD VILLAGE DR, SUITE Q, CARLSBAD, CA 92008-1957
(760) 500-3325
Mailing address
1207 CARLSBAD VILLAGE DR, SUITE Q, CARLSBAD, CA 92008-1957
(760) 500-3325
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
27991
CA
106H00000X
Marriage & Family Therapist
Primary
46057
CA
Other
Enumeration date
04/29/2015
Last updated
06/03/2015
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