| NPI | 1215440110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY REIN CEO 772-284-6216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 089365) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 35045) |
| 251S00000X | |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2018-03-17 |