| NPI | 1659706216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA M ANTONIO Manager/Owner 205-612-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1707) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-09-13 |