| NPI | 1194106476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA LIN COUCH Owner 479-219-5041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 12-01P) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |