| NPI | 1396363933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE MARIE DAVIS GOODWINE Clinical Psychologits 022-765-0965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 174H00000X Health Educator | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2022-06-09 |