| NPI | 1285123893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARIE SMITH Psychologist 339-970-4239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9419) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |