| NPI | 1013396324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELESTE SHOWERS SULC CEO 571-276-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003521) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810003521) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |