| NPI | 1437394103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL C CLARK Owner 334-300-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AL 1076) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-10 |