| NPI | 1043398993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM B FOLSOM Owner 602-749-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ LPC1772) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: AZ LISAC0023) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |