| NPI | 1134586191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA A ROBINSON Owner 4157-754-0451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25119) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-26 |