| NPI | 1023676574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOAD MICHELSEN Sole Mbr 210-468-2015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-08-27 |