| NPI | 1114682630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD KOSER Licensed Psychologist 856-313-5619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2021-11-01 |