| NPI | 1063920841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL NUSSBAUM President 844-888-0355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X | |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2020-06-08 |