| NPI | 1114894540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN REBMAN Owner 929-650-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |