| NPI | 1326084286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA DAWN EVANS Owner 606-585-7897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-06-12 |