| NPI | 1538802400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL COVERT Owner 623-200-6373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2022-04-18 |