| NPI | 1043717440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH INGALLS UMPHRIES Owner 318-918-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: AR 13-42EI) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |