| 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 |