| NPI | 1730637257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED PRUZAN CFO 561-990-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Additional Taxonomies | 111NR0400X |
| 171100000X Acupuncturist | |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2019-02-06 |