| NPI | 1497361745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET HANNAHAN President 251-421-4313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2021-02-26 |