| NPI | 1720648793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIYA SHERIFF Chief Executive Officer 866-489-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2019-06-20 |