| NPI | 1720435654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LEGG Clinical Psychologist 201-988-2388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 5576) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC006208) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2017-03-14 |