| NPI | 1003329632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JAMES KOEHN President 571-309-7993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2024-11-19 |