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 |