| NPI | 1215403340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEYSA FLORES Owner 678-845-8596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TH0004X Psychologist, Health | |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2018-10-16 |