| NPI | 1669231908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SANDOVAL CEO 857-217-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| 103TP0814X Psychologist, Psychoanalysis | |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-03-18 |