| NPI | 1164233417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLYSON FERNSTROM Owner 602-502-3806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-01-24 |