| NPI | 1235375387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CRUM Psychologist/Director 866-488-1965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL PY6618) |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2014-08-12 |