| NPI | 1588808745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE J MCGOVERN Manager/Owner 660-341-5030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist Health (Licence: AZ 4012) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |