| NPI | 1609030295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA E CARTER Billing/Office Manager 142-725-8062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 04379) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2018-05-19 |