| NPI | 1497201735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE SPARKS CEO 844-942-1789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251S00000X | |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2024-04-30 |