NPI | 1487950564 |
---|---|
Entity Type | Organization |
Authorized Contact | GERALYN DATZ Clinical Director/Owner 601-255-1618 |
Organization Subpart ? | No |
Primary Taxonomy | 103TH0004X Psychologist, Health |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
103TC0700X Psychologist, Clinical | |
Enumeration Date | 2011-02-07 |
Last Update Date | 2013-01-15 |