| NPI | 1639610553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH EAPPEN Owner 844-632-7736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2018-07-02 |