| NPI | 1578231676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE CREA-KAMMERER Owner 096-221-4863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TC0700X Psychologist, Clinical | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2021-09-02 |