| NPI | 1093108029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C. NEEDHAM Licensed Psychologist 323-686-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: HI PSY-1508) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |