| NPI | 1487480372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK HOWARD Co Owner 334-209-4755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TE1100X Psychologist, Exercise & Sports | |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |