| NPI | 1245536853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SCHROEDER Owner 960-455-9879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: CT 028905) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2014-05-21 |