| NPI | 1366812968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL D TAYLOR-DIETZ Psychologist 401-451-6242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1001056) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |