| NPI | 1265550578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA L MACK Licensed Clinical Psyhologist 202-529-3117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 103T00000X Psychologist | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2014-02-24 |