| NPI | 1043485543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C VAN ROSEN President 251-621-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC0700X Psychologist Clinical | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0000X Psychologist Family | |
| 103TF0200X Psychologist Forensic | |
| 103TH0004X Psychologist Health | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |