| NPI | 1528832615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP ANTHONY SUESS Psychologist/Owner 308-360-3606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2023-11-09 |