| NPI | 1184263980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE O'SULLIVAN Owner 551-250-1017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 101YM0800X Counselor, Mental Health | |
| 103G00000X Clinical Neuropsychologist | |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |