| NPI | 1023522588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J ECONOMOU Director, CEO 866-369-1090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC1900X Psychologist, Counseling | |
| 103TE1100X Psychologist, Exercise & Sports | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2018-03-17 |