| NPI | 1467871772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMYANNE FREEBURG President 800-792-9129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY22152) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: CA PSY22152) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-10-24 |