| NPI | 1457915605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY A COHEN Owner/CEO 424-532-1552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-06-11 |