| NPI | 1487000345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE FULLER Psychologist 202-955-6381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC Psy1827) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |