| NPI | 1104385327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN DAVIS Licensed Psychologist 201-523-5499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-03-07 |