| NPI | 1033477872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER A WEISS Psychologist 8083-297-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: HI PSY-267) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2012-04-30 |