| NPI | 1578229365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRETT DWYER Chief Financial Officer 888-224-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2024-11-13 |