| NPI | 1649922527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MICHAEL TARESCAVAGE Psychologist 216-714-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TF0200X Psychologist, Forensic | |
| Enumeration Date | 2022-01-22 |
| Last Update Date | 2022-01-22 |