| NPI | 1659078939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL TIERNEY Medical Director, Owner 855-675-1849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2023-02-08 |