| NPI | 1528657517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVANS MADAGA Aa Representative 302-690-4067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2021-01-13 |