| NPI | 1194203414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC COOPER Clinical Director 334-539-7017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AL 1508007436) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |