| NPI | 1639868524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAPHAEL ROMERO President/Owner 854-205-6386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 106H00000X Marriage & Family Therapist | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0801X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 282J00000X Religious Nonmedical Health Care Institution | |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional | |
| 103G00000X Clinical Neuropsychologist | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-10-12 |