NPI | 1104170596 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA A STOKES President Clinical Psychologist 712-574-9220 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 01004) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IA 12R099) | |
103TC0700X Psychologist, Clinical (Licence: IA 00475) | |
Enumeration Date | 2012-11-06 |
Last Update Date | 2023-09-25 |