| NPI | 1619480357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIANE CREVELING-BENEFIELD Owner 225-405-4401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: LA 1296) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-15 |