| NPI | 1093184210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA SEWELL SHORT Licensed Psychologist 501-291-3091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist Group Psychotherapy |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2019-09-06 |