| NPI | 1255708822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINNE CECILE DATCHI Single Owner 812-360-5143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35SI00535000) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ 35SI00535000) |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2015-08-30 |