| NPI | 1124641725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE A ALVARADO Licensed Clinical Psychologist 571-248-2145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-05-19 |