| NPI | 1326695271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREN R MOORE Owner/Licensed Psychologist 501-500-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 101YS0200X Counselor School | |
| 103TF0000X Psychologist Family | |
| 103TS0200X Psychologist School | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 1041S0200X Social Worker School | |
| 251B00000X Case Management | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2024-02-19 |