| NPI | 1568849446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVONDA BEAN President 980-939-5099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-04-30 |