| NPI | 1639925936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENOWOGHOMWENMA OSAGHAE Clinical Director 628-235-7731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-04-26 |