| NPI | 1235497744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WILLIAM GAINES Owner 201-444-9866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 3956) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2012-06-06 |