| NPI | 1407155336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLA CAVENAGH Licensed Psychologist/Group Admin 267-536-9860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016868) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |