| NPI | 1336943232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATEUSZ DZIKOWSKI Member 331-231-8895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2025-04-02 |