| NPI | 1720716947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MALONE Owner 888-515-3834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2023-01-20 |