| NPI | 1033725676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY MARIE WAMSAT Licensed Clinical Psychologist 872-225-6391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |