| NPI | 1487473575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN BENNETT President 949-291-2736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-07 |