| NPI | 1235993130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY ODOZI Psychologist 424-225-0964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2025-04-09 |