| NPI | 1487271763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN MATTHEWS Owner 848-299-9329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2020-07-02 |