| NPI | 1538807011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA DEWEY Manager 267-226-0445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2024-02-28 |