| NPI | 1649900259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM NILES LINGARD Clinical Psychologist 215-817-7168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-08-02 |