| NPI | 1548751290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH VINCENT ANGARELLA Operations Managager 747-389-3197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA PSY19955) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY19955) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY19955) | |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY19955) | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2019-09-06 |