| NPI | 1477821544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON L BROENNIMANN Clinical Psychologist 888-667-4828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 24463) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2011-12-05 |