| NPI | 1184376048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN LIMA Owner 360-347-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-01-21 |