| NPI | 1295387868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONESHA KING CEO 026-560-6272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2021-02-16 |