| NPI | 1306644604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILLICENT MALDONADO Chief Psychologist 939-202-9296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-03-04 |
| Last Update Date | 2025-03-04 |