| NPI | 1255717500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH E PULVER Psychotherapist 267-574-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA SW131112) |
| Enumeration Date | 2015-08-09 |
| Last Update Date | 2015-08-09 |