| NPI | 1720821077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW S PRESTON Owner 984-287-8998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-06-14 |