| NPI | 1154604007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN GALLAGHER Licensed Psychologist 267-847-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: PA PS016416) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |