| NPI | 1467005579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY DANE GINDER Authorized Representative 909-799-3777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical | |
| 174400000X Specialist | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2023-08-01 |