NPI | 1689262891 |
---|---|
Entity Type | Organization |
Authorized Contact | COURTNEY AINSWORTH IVESS Associate Director 571-366-8831 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 103TC0700X Psychologist, Clinical |
103TC1900X Psychologist, Counseling | |
Enumeration Date | 2021-01-04 |
Last Update Date | 2021-01-04 |