| NPI | 1376623769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL A BONNACCI President 623-915-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: AZ 3376) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-12-13 |