| NPI | 1447764246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHITAL P GAITONDE Owner 918-691-1237 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003646) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2017-12-01 |