| NPI | 1023882404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA P SULLIVAN Ambr 954-253-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2025-06-17 |