NPI | 1477655314 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELE MATTIE Owner 570-718-1150 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS008609L) |
Enumeration Date | 2006-09-01 |
Last Update Date | 2020-08-22 |