| NPI | 1083594154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIBERTY EBERLY Authorized Official 999-999-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-09-17 |