| NPI | 1639822109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE ANN CAVENAGH Licensed Psychologist/Practice Owne 702-912-5848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2022-02-03 |