| NPI | 1629097274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK W LAWSON Clinical Psychologist 607-664-4305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: AR 94-27P) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AR 94-27P) |
| 103TC0700X Psychologist, Clinical (Licence: AR 94-27P) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: AR 94-27P) | |
| 103T00000X Psychologist (Licence: AR 94-27P) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: AR 94-27P) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |