| NPI | 1619913258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE CAPOCCIA Credentialing 480-797-1571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2025-01-24 |