| NPI | 1669964185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELIYVETTE WORKMAN Director Of Managed Care & Contract 856-566-6831 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2022-12-05 |