NPI | 1437713062 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTIN ANCONA Ph.D 214-662-1791 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2019-04-29 |
Last Update Date | 2019-10-09 |