| NPI | 1447034871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIDEL CRUZ President 725-205-1578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2025-06-25 |