| NPI | 1447565866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D. GOODMAN Licensed Psychologist 620-727-6569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 374) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |