| NPI | 1598102246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PERRT JOHNSON President 267-419-8532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS004933L) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2014-03-12 |