| NPI | 1205459492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISA MARIE DANZ Sole Owner 808-798-8781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2023-08-21 |