| NPI | 1154625127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE MCKENNA Psychologist 479-254-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 10-07P) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |