| NPI | 1609162239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID JACOBS Psychologist 479-236-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AR 10-11P) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |