| NPI | 1285371781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ALICE ETKIND Owner 703-673-7113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2023-01-17 |