| NPI | 1336721869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK SHEETS Owner/Operator 302-339-7962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-04-23 |