Organization
VR BIOFEEDBACK FOCUSED PSYCHOTHERAPY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY GRUPE LMFT (CEO)
(949) 391-3849
Entity
Organization
Contact information
Practice address
30131 TOWN CENTER DR STE 292, LAGUNA NIGUEL, CA 92677-2086
(949) 391-3849
Mailing address
21 S MONTILLA, SAN CLEMENTE, CA 92672-6000
(949) 391-3849
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235479395
NPI
—
Enumeration date
09/03/2017
Last updated
09/03/2017
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