| NPI | 1699150979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUL SANCHEZ President 712-271-6463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 01010) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |