| NPI | 1134212335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRUCE FANE Licensed Psychologist/Owner 270-393-9833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: KY 1104) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-08-28 |