| NPI | 1053855734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEL ANTHONY VAN EERD Executive Director 480-277-5919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60611766) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |