| NPI | 1114702321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN BEITEL Owner 980-222-4486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-09-28 |