| NPI | 1568836930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN ROMEO Clinical Psychologist 704-872-5990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 2207) |
| Enumeration Date | 2015-11-21 |
| Last Update Date | 2015-11-21 |